Provider Demographics
NPI:1831531417
Name:SHAFI, IMRAN (PA)
Entity type:Individual
Prefix:
First Name:IMRAN
Middle Name:
Last Name:SHAFI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9380 W SAM HOUSTON PKWY S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-5222
Mailing Address - Country:US
Mailing Address - Phone:832-300-2626
Mailing Address - Fax:832-300-2625
Practice Address - Street 1:1227 MUSEUM SQUARE DR STE A
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4630
Practice Address - Country:US
Practice Address - Phone:281-915-9041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08502363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant