Healthcare Provider Details

I. General information

NPI: 1003171091
Provider Name (Legal Business Name): DR. NAWAL SHAIKH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAWAL SHAIKH M.D.

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S MAIN ST STE 502
FORT WORTH TX
76104-4909
US

IV. Provider business mailing address

5353 HARRY HINES BLVD DEPT OF NEUROLOGY
DALLAS TX
75390-7208
US

V. Phone/Fax

Practice location:
  • Phone: 817-702-8400
  • Fax: 817-702-3982
Mailing address:
  • Phone: 214-648-3571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number125.069390
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberMD457314
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberT8731
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA12748500
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25867
License Number StateMS
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT202846
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberT8731
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25867
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: