MEDICARE: TAGHI SHAFIE 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	2084P0800X	Psychiatry Physician	F3331	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8S4341	OTHER	TX	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1568478352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAGHI SHAFIE M.D.

Provider Business Mailing Address
First Line	:	4352 EMMETT F LOWRY EXPY
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2628
Country	:	US
Telephone Number	:	409-763-2373
Fax Number	:	409-948-1411

Provider Business Practice Location Address
First Line	:	7510 FM 1765
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77590
Country	:	US
Telephone Number	:	409-935-6083
Fax Number	:	409-935-0127

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/08/2007

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Directions to “ TAGHI SHAFIE M.D.” Practice Location

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