Physician Compare National (NPI:1619249653)

HEALTHCARE PROVIDER: ZIYAD SHAKLAH NP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1619249653
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002062668
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120814000400
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHAKLAH
	Individual professional last name
Provider First Name	ZIYAD
	Individual professional first name
Provider Middle Name	MAHMOUD HASAN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1111 ROCKINGHAM DR
	Group Practice or individual's line 1 address
City	RICHARDSON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750804309
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y