Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | L9474 | TX |
N | 2080P0214X | Pediatric Pulmonologist | L9474 | TX |
NPI | 1659318897 |
---|---|
Provider Name | Dr. Keisha Mari Shaheed |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 06/05/2021 |