# SHAFA MOBILE DIAGNOSTIC MANAGEMENT INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568865525
- **Authorized official:** MR. NIZAR ALIKHAN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (301) 591-4184

## Contact information

- **Practice address:** 2801 REGAL RD, STE 110, PLANO, TX 75075-6315
- **Practice address phone:** (972) 612-2600
- **Practice address fax:** (972) 612-2602
- **Mailing address:** 2801 REGAL RD, STE 110, PLANO, TX 75075-6315
- **Mailing address phone:** (972) 612-2600
- **Mailing address fax:** (972) 612-2602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |
| 261QR0208X | Mobile Radiology Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/06/2014
- **Last updated:** 12/18/2014