Provider Demographics
NPI:1952990590
Name:DHUKA, SHAFEEN SADRUDDIN (PT)
Entity Type:Individual
Prefix:
First Name:SHAFEEN
Middle Name:SADRUDDIN
Last Name:DHUKA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8214 DRAGONFLY DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-1832
Mailing Address - Country:US
Mailing Address - Phone:832-951-0431
Mailing Address - Fax:
Practice Address - Street 1:8214 DRAGONFLY DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-1832
Practice Address - Country:US
Practice Address - Phone:832-951-0431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1268307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty