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General NPI Number Information
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NPI Number | 1417174913
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Entity Type | Individual
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Provider Name | FATEN MOHAMED SHABAREK M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 4102 WOODLAWN AVE SUITE # 220
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City | PASADENA
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State | TX
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Zip | 77504-1947
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Country | US
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Telephone | 713-475-5940
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Fax | 713-477-6527
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Provider Business Mailing Address
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Address Line | 4102 WOODLAWN AVE SUITE # 220
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City | PASADENA
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State | TX
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Zip | 77504-1947
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Country | US
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Telephone |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | J1782
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License Number State | TX
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