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General NPI Number Information
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NPI Number | 1073134151
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Entity Type | Individual
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Provider Name | FARAHNAZ SHAFIEY
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Gender | Female
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 520 MADISON OAK DR
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3913
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Country | US
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Telephone | 210-297-4007
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Fax |
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Provider Business Mailing Address
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Address Line | 6363 SAN FELIPE ST APT 468
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City | HOUSTON
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State | TX
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Zip | 77057-2766
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Country | US
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Telephone | 832-954-6943
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number |
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License Number State | TX
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