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General NPI Number Information
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NPI Number | 1508060740
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Entity Type | Organization
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Legal Business Name | SHANTI PAIN & WELLNESS CLINIC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5611 BELLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77081-5617
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Country | US
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Telephone | 713-339-1566
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Fax | 713-465-5965
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Provider Business Mailing Address
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Address Line | 5611 BELLAIRE BLVD # 376
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City | HOUSTON
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State | TX
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Zip | 77081-5617
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Country | US
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Telephone | 713-339-1566
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Fax | 713-465-5965
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Authorized Official
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Title or Position | OWNER
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Name | IHSAN F SHANTI
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Credential | MD
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Telephone | 713-339-1566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | K4562
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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