Healthcare Provider Details

I. General information

NPI: 1508177718
Provider Name (Legal Business Name): SOLAFA ELSHATANOUFY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W GRAND PKWY S STE 320
KATY TX
77494-8364
US

IV. Provider business mailing address

410 W GRAND PKWY S STE 320
KATY TX
77494-8364
US

V. Phone/Fax

Practice location:
  • Phone: 281-957-6787
  • Fax:
Mailing address:
  • Phone: 281-957-6787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301099415
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberR8733
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: