Provider Demographics
NPI:1366584021
Name:NAZ, SHEHLA (MD)
Entity type:Individual
Prefix:
First Name:SHEHLA
Middle Name:
Last Name:NAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 ROYAL LN
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-1830
Mailing Address - Country:US
Mailing Address - Phone:214-902-0000
Mailing Address - Fax:214-902-0002
Practice Address - Street 1:9901 ROYAL LN
Practice Address - Street 2:SUITE 106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-1830
Practice Address - Country:US
Practice Address - Phone:214-902-0000
Practice Address - Fax:214-902-0002
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9535207Q00000X
OK23955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282390801Medicaid
TX282390801Medicaid