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Individual

MUSSARAT SHAFIQ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
400 HOSPITAL DR, STE 208, CORSICANA, TX 75110-2489
(903) 654-4564
(903) 654-6837
Mailing address
2403 N LAURENT ST, VICTORIA, TX 77901-4119
(361) 579-0315
(361) 579-0325

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME93798
FL
208000000X
Pediatrics Physician
Primary
N4737
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000552361
ANTHEM/BCBS
OH
05
273813900
FL
01
8CF759
BLUE CROSS
TX
Enumeration date
08/31/2006
Last updated
12/01/2011
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