Provider Demographics
NPI:1669979704
Name:SHAHAB, YOUSRA (MD)
Entity type:Individual
Prefix:DR
First Name:YOUSRA
Middle Name:
Last Name:SHAHAB
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 1:3636 W DALLAS ST UNIT 533
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-1779
Mailing Address - Country:US
Mailing Address - Phone:347-963-2832
Mailing Address - Fax:
Practice Address - Street 1:10623 BELLAIRE BLVD STE C280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-5242
Practice Address - Country:US
Practice Address - Phone:713-486-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA174530208000000X
TXT9796208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics