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General NPI Number Information
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NPI Number | 1366637332
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Entity Type | Individual
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Provider Name | MOIZ MUSTANSHIR SHAFIQ MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 560 W MAIN ST STE 205
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City | LEWISVILLE
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State | TX
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Zip | 75057-3604
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Country | US
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Telephone | 972-972-4252
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Fax | 877-277-3002
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Provider Business Mailing Address
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Address Line | 9500 VALLEY LAKE LN
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City | IRVING
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State | TX
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Zip | 75063-5012
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Country | US
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Telephone | 214-924-4073
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M4527
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | M4527
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License Number State | TX
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