Provider Demographics
NPI:1154940922
Name:SHAIKH, AFSHAN (PT, MPT, CLT)
Entity type:Individual
Prefix:
First Name:AFSHAN
Middle Name:
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:PT, MPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BEN LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-2041
Mailing Address - Country:US
Mailing Address - Phone:719-237-4238
Mailing Address - Fax:
Practice Address - Street 1:600 E JOHN CARPENTER FWY STE 354
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4320
Practice Address - Country:US
Practice Address - Phone:972-556-5667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1329473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist