Individual
SHAMILA MAUIYYEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-1011
(409) 772-5683
Mailing address
6431 FANNIN STREET, MSB 2.136, HOUSTON, TX 77030-1501
(713) 500-5301
(713) 500-0695
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
L5458
TX
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
L5458
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148886801
—
TX
01
—
220031852
RAILROAD MEDICARE
TX
01
—
8F2330
BCBS
TX
Enumeration date
05/20/2006
Last updated
05/21/2024
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