Provider Demographics
NPI:1962602904
Name:SHAD, ZOHRA (MD)
Entity type:Individual
Prefix:DR
First Name:ZOHRA
Middle Name:
Last Name:SHAD
Suffix:
Gender:F
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:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:2459 E HEBRON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4477
Practice Address - Country:US
Practice Address - Phone:972-757-0345
Practice Address - Fax:972-767-0335
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35099265207SG0201X
IL036133413207SG0201X
TXS0084208000000X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX393055407Medicaid
TX393055403Medicaid
TX393055401Medicaid
AR440164701OtherAR MEDICAID TEMP RX #