Provider Demographics
NPI:1649262007
Name:QURAISHI, SHAMA P (MD)
Entity type:Individual
Prefix:
First Name:SHAMA
Middle Name:P
Last Name:QURAISHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7641
Mailing Address - Country:US
Mailing Address - Phone:409-832-7195
Mailing Address - Fax:409-832-8199
Practice Address - Street 1:2342 DOWLEN RD STE 102
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-2537
Practice Address - Country:US
Practice Address - Phone:409-781-3698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine