MEDICARE: DR. HASHEM M. SHALTONI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	M0267	TX
2	2084N0400X	Neurology Physician	M0267	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8R6141	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1255367710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HASHEM M. SHALTONI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 650859, DEPT. 710
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0859
Country	:	US
Telephone Number	:	409-772-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2660 GULF FWY S
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-6820
Country	:	US
Telephone Number	:	832-505-2350
Fax Number	:	281-309-0419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	04/25/2023

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