Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | K3076 | TX |
Y | 207KA0200X | Allergist | K3076 | TX |
NPI | 1235204082 |
---|---|
Provider Name | Shahid A Bangash |
First Address | Brownsville, TX 78521-3508 |
Second Address | Brownsville, TX 78521-3508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 27/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100683505 | (05) | TX |
8V3621 | BLUE CROSS BLUE SHIELD (01) | TX |
G58797 | (02) | TX |