Individual
DR. KEISHA MARI SHAHEED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-6299
(682) 885-1090
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
L9474
TX
2080P0214X
Pediatric Pulmonology Physician
L9474
TX
2080S0012X
Pediatric Sleep Medicine Physician
Primary
L9474
TX
Other
Enumeration date
05/31/2006
Last updated
05/06/2021
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