Provider Demographics
NPI:1417516691
Name:AMLANI, SHIRIN (DO)
Entity type:Individual
Prefix:
First Name:SHIRIN
Middle Name:
Last Name:AMLANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 IRON BROOK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4057
Mailing Address - Country:US
Mailing Address - Phone:678-849-0395
Mailing Address - Fax:
Practice Address - Street 1:7616 BRANFORD PL
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3793
Practice Address - Country:US
Practice Address - Phone:678-849-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.2554207Q00000X
TXV3821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine