Individual
MAHDOKHT SHAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4308 MALLARD LN, SACHSE, TX 75048-3950
(214) 601-1023
Mailing address
4308 MALLARD LN, SACHSE, TX 75048-3950
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
19711160370
TX
Other
Enumeration date
08/08/2011
Last updated
08/08/2011
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