Individual
DR. SHAADI KHADEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7777
Mailing address
PO BOX 731912, DALLAS, TX 75373-1912
(903) 877-7777
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
BP10053903
TX
2083X0100X
Occupational Medicine Physician
Primary
R3121
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2012
Last updated
07/21/2022
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