Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10042773 | TX |
N | 111NI0900X | Internist | BP10042773 | TX |
Y | 2084N0400X | Neurologist | Q8302 | TX |
NPI | 1013275676 |
---|---|
Provider Name | Shamin Masrour |
First Address | Dallas, TX 75390-7208 |
Second Address | Dallas, TX 75390-1930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 19/06/2017 |