=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417284084
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JULIO SHAHAR MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2009
-----------------------------------------------------
Last Update Date | 01/21/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13111 EAST FWY STE 304
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77015-5819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-455-9030
-----------------------------------------------------
Fax | 713-455-8956
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13111 EAST FWY STE 304
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77015-5819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-455-9030
-----------------------------------------------------
Fax | 713-455-8956
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JULIO SHAHAR
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 713-455-9030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | H6954
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------