Provider Demographics
NPI:1174527766
Name:SHAFIQ, KHALID (MD, FACC, FSCAI)
Entity type:Individual
Prefix:
First Name:KHALID
Middle Name:
Last Name:SHAFIQ
Suffix:
Gender:M
Credentials:MD, FACC, FSCAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 FARM ROAD 195
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-2855
Mailing Address - Country:US
Mailing Address - Phone:903-739-2700
Mailing Address - Fax:903-784-1749
Practice Address - Street 1:1775 FARM ROAD 195
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-2855
Practice Address - Country:US
Practice Address - Phone:903-739-2700
Practice Address - Fax:903-784-1749
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2588207RI0011X, 207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130896707Medicaid
OK100049730BMedicaid
TX060052969OtherRAILROAD MEDICARE
TX8CR957OtherBCBS
TX130896707Medicaid
TX8CR957OtherBCBS