Individual
OMAR IHSAN SHISHAKLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10902 KATY FWY APT 1904, HOUSTON, TX 77043-4915
(832) 858-0955
Mailing address
10902 KATY FWY APT 1904, HOUSTON, TX 77043-4915
(832) 858-0955
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT81652
TX
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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