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NPI Code Detail

MEDICARE: SHAMJI P BADHIWALA MD

MEDICARE: SHAMJI P BADHIWALA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianH3440TX

General Provider Information

NPI Number : 1700841251
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAMJI P BADHIWALA MD
Provider Business Mailing Address
First Line : 716 AUBURN CT
Second Line :
City : SAVANNAH
State : TX
Zip : 76227-7924
Country : US
Telephone Number : 214-704-7328
Fax Number : 972-852-9016
Provider Business Practice Location Address
First Line : 110 S 12TH ST
Second Line :
City : WACO
State : TX
Zip : 76701-1810
Country : US
Telephone Number : 254-752-3451
Fax Number : 972-852-9016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2006
Last Update Date : 11/18/2020

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Directions to “ SHAMJI P BADHIWALA MD” Practice Location

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