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General NPI Number Information
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NPI Number | 1073060331
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Entity Type | Organization
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Legal Business Name | ID CLINIC CONSULTANTS PLLC
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Dates
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Enumeration Date | 09/04/2016
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Last Update Date | 09/04/2016
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Provider Practice Location Address
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Address Line | 908 AUDELIA RD STE 200 #323
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City | RICHARDSON
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State | TX
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Zip | 75081-5166
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Country | US
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Telephone | 972-947-3200
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Fax | 972-947-3201
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Provider Business Mailing Address
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Address Line | 908 AUDELIA RD STE 200 #323
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City | RICHARDSON
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State | TX
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Zip | 75081-5166
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Country | US
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Telephone | 972-947-3200
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Fax | 972-947-3201
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ZAKIR HUSSAIN A SHAIKH
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Credential | MD
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Telephone | 972-947-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | K9168
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License Number State | TX
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