Provider Demographics
NPI:1396269940
Name:SHAMSI, FARYAAL (DDS)
Entity type:Individual
Prefix:DR
First Name:FARYAAL
Middle Name:
Last Name:SHAMSI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 HAT BENDER LOOP
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-2081
Mailing Address - Country:US
Mailing Address - Phone:281-987-5415
Mailing Address - Fax:
Practice Address - Street 1:1801 E 51ST ST STE 390
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3444
Practice Address - Country:US
Practice Address - Phone:512-669-5147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33385OtherTEXAS DENTAL LICENSE NUMBER