Provider Demographics
NPI:1023048113
Name:KAMAL, LUBNA SHAHID (MD)
Entity type:Individual
Prefix:DR
First Name:LUBNA
Middle Name:SHAHID
Last Name:KAMAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3833 LAKEDALE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3764
Mailing Address - Country:US
Mailing Address - Phone:469-733-3131
Mailing Address - Fax:972-303-6200
Practice Address - Street 1:5506 BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-3639
Practice Address - Country:US
Practice Address - Phone:972-303-7070
Practice Address - Fax:972-303-4343
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2224208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84250YOtherBLUE SHIELD
TX130859503Medicaid
TXG41947Medicare UPIN