Provider Demographics
NPI:1386754141
Name:SHAHAR, JULIO (MD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:SHAHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 EAST FWY
Mailing Address - Street 2:STE 304
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5803
Mailing Address - Country:US
Mailing Address - Phone:713-455-9030
Mailing Address - Fax:713-455-8956
Practice Address - Street 1:13111 EAST FWY
Practice Address - Street 2:STE 304
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5803
Practice Address - Country:US
Practice Address - Phone:713-455-9030
Practice Address - Fax:713-455-8956
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH954207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139419915Medicaid
TX0A5638Medicare PIN
E48624Medicare UPIN