Provider Demographics
NPI:1124019260
Name:PARVEZ, SHABANA (MD)
Entity type:Individual
Prefix:
First Name:SHABANA
Middle Name:
Last Name:PARVEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:SHABANA
Other - Middle Name:
Other - Last Name:VALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2831 OAK GLEN CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0401
Mailing Address - Country:US
Mailing Address - Phone:682-256-2749
Mailing Address - Fax:833-295-9082
Practice Address - Street 1:2831 OAK GLEN CT
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0401
Practice Address - Country:US
Practice Address - Phone:682-256-2749
Practice Address - Fax:833-295-9082
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7506207P00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM54007267Medicaid
TX8AA312OtherBCBS
TX8AB545OtherBCBSTX
TXP00879699OtherRRMCARE THRU HEB
TX188377906Medicaid
TX188377901Medicaid
TX8K0147Medicare PIN
TX188377906Medicaid
TX188377901Medicaid