Provider Demographics
NPI:1568446243
Name:SHAIB, FIDAA H (MD)
Entity type:Individual
Prefix:
First Name:FIDAA
Middle Name:H
Last Name:SHAIB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6620 MAIN ST
Mailing Address - Street 2:STE 11C.06
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2348
Mailing Address - Country:US
Mailing Address - Phone:713-798-2400
Mailing Address - Fax:713-798-2791
Practice Address - Street 1:7200 CAMBRIDGE ST FL 8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:713-798-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38056207RP1001X, 207RS0012X
TXP4381207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64095664Medicaid
KY64095664Medicaid
KY00477004Medicare PIN
KYI25577Medicare UPIN