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Individual

DIBA SHABANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1227 MUSEUM SQUARE DR STE A, SUGAR LAND, TX 77479-4630
(281) 915-9041
Mailing address
2225 WILLIAMS TRACE BLVD STE 110, SUGAR LAND, TX 77478-4440
(281) 491-1911

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2021011607
363A00000X
Physician Assistant
Primary
PA16260
TX

Other

Enumeration date
09/30/2021
Last updated
09/19/2024
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