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General NPI Number Information
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NPI Number | 1275332918
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Entity Type | Individual
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Provider Name | SHAMAL LORD
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Gender | Male
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 6720 BERTNER AVE
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City | HOUSTON
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State | TX
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Zip | 77030-2604
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Country | US
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Telephone | 832-355-2666
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Fax |
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Provider Business Mailing Address
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Address Line | 22799 OAKGROVE RD
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City | STERLING
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State | VA
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Zip | 20166-4367
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Country | US
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Telephone | 571-224-6526
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001290486
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1200930
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0001290486
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | 1200930
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License Number State | TX
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