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Individual
MS. MARISSA LEIGH SHAFEI
Active
Individual
MS. MARISSA LEIGH SHAFEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07753
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
294239305
—
TX
05
—
294239306
—
TX
01
—
294239307
MEDICAID CSHCN
TX
01
—
8HX831
BCBS
TX
Enumeration date
03/01/2012
Last updated
04/12/2023
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