Provider Demographics
NPI:1063602399
Name:SHAKIR, MURTAZA (MD)
Entity type:Individual
Prefix:DR
First Name:MURTAZA
Middle Name:
Last Name:SHAKIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:410 W GRAND PKWY S STE 4D
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8361
Mailing Address - Country:US
Mailing Address - Phone:713-955-9191
Mailing Address - Fax:832-626-4099
Practice Address - Street 1:410 W GRAND PKWY S STE 4D
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8361
Practice Address - Country:US
Practice Address - Phone:713-955-9191
Practice Address - Fax:281-918-7392
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4142208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX377096801Medicaid