Provider Demographics
NPI:1366920407
Name:QURESHI, MAHLAQA SHAHEN (LAC,MAO)
Entity type:Individual
Prefix:
First Name:MAHLAQA
Middle Name:SHAHEN
Last Name:QURESHI
Suffix:
Gender:F
Credentials:LAC,MAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W RENNER RD APT 2415
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1041
Mailing Address - Country:US
Mailing Address - Phone:214-592-2494
Mailing Address - Fax:
Practice Address - Street 1:1217 W STATE HIGHWAY 114 STE 124
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3995
Practice Address - Country:US
Practice Address - Phone:214-592-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01797171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist