Provider Demographics
NPI:1912138165
Name:SHAFIE, EL SHERIF OMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:EL SHERIF OMAR
Middle Name:
Last Name:SHAFIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EL SHERIF OMAR
Other - Middle Name:ASHRAF OMAR
Other - Last Name:SHAFIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12000 RICHMOND AVE
Mailing Address - Street 2:STE 333
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2431
Mailing Address - Country:US
Mailing Address - Phone:734-250-3470
Mailing Address - Fax:
Practice Address - Street 1:12000 RICHMOND AVE STE 330
Practice Address - Street 2:SUITE 330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2428
Practice Address - Country:US
Practice Address - Phone:713-334-2330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5722207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine