Provider Demographics
NPI:1528113172
Name:BADAR, SHAHID (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHID
Middle Name:
Last Name:BADAR
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 1:6406 LAZY TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5581
Mailing Address - Country:US
Mailing Address - Phone:281-372-1144
Mailing Address - Fax:281-322-0113
Practice Address - Street 1:6406 LAZY TRAIL CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5581
Practice Address - Country:US
Practice Address - Phone:281-721-4455
Practice Address - Fax:281-220-1316
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002031946207R00000X
TXQ3145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208402909Medicaid
MO000014551Medicare ID - Type Unspecified
MO208402909Medicaid