Individual
DR. LORI ANN SHAHIDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
305 MIRON DR, SOUTHLAKE, TX 76092-7831
(817) 488-1950
(817) 305-0162
Mailing address
305 MIRON DRIVE, SOUTHLAKE, TX 76092-7826
(817) 488-1950
(817) 305-0162
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M9648
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195601301
—
TX
01
—
8X5113
BCBS
TX
01
—
P00736997
RAILROAD MEDICARE
TX
Enumeration date
04/17/2008
Last updated
04/01/2013
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