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General NPI Number Information
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NPI Number | 1417152182
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Entity Type | Individual
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Provider Name | ROOPAM SHYAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 1420 W EXCHANGE PKWY STE 120
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City | ALLEN
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State | TX
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Zip | 75013-4696
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Country | US
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Telephone | 972-521-6210
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Fax |
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Provider Business Mailing Address
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Address Line | 2033 W MCDERMOTT DR STE 320-182
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City | ALLEN
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State | TX
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Zip | 75013-4694
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Country | US
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Telephone | 469-247-9690
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M6396
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License Number State | TX
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