MEDICARE: SHUAB OMER 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	2011016782	MO

General Provider Information

NPI Number	:	1730333204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUAB OMER M.D.

Provider Business Mailing Address
First Line	:	12559 POSTGROVE DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4537
Country	:	US
Telephone Number	:	419-260-7301
Fax Number	:

Provider Business Practice Location Address
First Line	:	21216 NORTHWEST FWY STE 670
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-4697
Country	:	US
Telephone Number	:	281-970-6500
Fax Number	:

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

Provider Enumeration Date	:	11/11/2008
Last Update Date	:	09/28/2020

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