Provider Demographics
NPI:1124513270
Name:SHAGUFTA, SHANILA (MD)
Entity type:Individual
Prefix:
First Name:SHANILA
Middle Name:
Last Name:SHAGUFTA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 HOSPITAL PKWY STE 407
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6932
Mailing Address - Country:US
Mailing Address - Phone:972-573-3855
Mailing Address - Fax:833-973-4597
Practice Address - Street 1:12850 DALLAS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-0844
Practice Address - Country:US
Practice Address - Phone:469-678-7802
Practice Address - Fax:833-972-5253
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU55172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry