# SHAMOON DOCTOR, MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shamoon Doctor, MD PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396360962
- **Authorized official:** SHAMOOM DOCTOR MD (PHYSICIAN OWNER)
- **Authorized official phone:** (830) 313-6032

## Contact information

- **Practice address:** 612 N BEDELL AVE STE A, DEL RIO, TX 78840-4173
- **Practice address phone:** (830) 313-6032
- **Mailing address:** 804 EVENTIDE DR, SAN ANTONIO, TX 78209-5520
- **Mailing address phone:** (830) 313-6032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/10/2020
- **Last updated:** 06/10/2020