Healthcare Provider Details

I. General information

NPI: 1265366249
Provider Name (Legal Business Name): AMMAR AMIN MOHAMMAD AL SHALBY M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UTMB GME C/O E. ESPINO 301 UNIVERSITY BLVD, 5.138 RS
GALVESTON TX
77555
US

IV. Provider business mailing address

620 GRAY STONE LN
RICHARDSON TX
75081
US

V. Phone/Fax

Practice location:
  • Phone: 409-747-0534
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberBP10098496
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: