Provider Demographics
NPI:1700019874
Name:SHAIK, ZAKIR HUSAIN (MD)
Entity Type:Individual
Prefix:
First Name:ZAKIR
Middle Name:HUSAIN
Last Name:SHAIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 HARRISON ST STE 222
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1100
Mailing Address - Country:US
Mailing Address - Phone:409-892-1003
Mailing Address - Fax:409-892-2655
Practice Address - Street 1:2965 HARRISON ST STE 222
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1100
Practice Address - Country:US
Practice Address - Phone:409-892-1003
Practice Address - Fax:409-892-2655
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443086207R00000X, 208M00000X
TXS8249207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA824305OtherMLHC BS AA #
PA037276OtherMLHC MEDICARE AA #
TX1700019874Medicaid