Provider Demographics
NPI:1518096379
Name:MOHAMED SHALABY, MD, PA
Entity type:Organization
Organization Name:MOHAMED SHALABY, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHALABY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-409-4090
Mailing Address - Street 1:450 MEDICAL CENTER BLV
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:713-409-4090
Mailing Address - Fax:281-335-4529
Practice Address - Street 1:450 MEDICAL CENTER BLVD
Practice Address - Street 2:510
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4234
Practice Address - Country:US
Practice Address - Phone:713-409-4090
Practice Address - Fax:281-335-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8951207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH79593Medicare UPIN