Provider Demographics
NPI:1972698488
Name:HOUSTON NEUROCARE, P.A.
Entity type:Organization
Organization Name:HOUSTON NEUROCARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAIBANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-795-0033
Mailing Address - Street 1:6624 FANNIN ST.
Mailing Address - Street 2:SUITE 1670
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-795-0033
Mailing Address - Fax:713-796-9302
Practice Address - Street 1:6624 FANNIN ST.
Practice Address - Street 2:SUITE 1670
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-795-0033
Practice Address - Fax:713-796-9302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ50332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXZ000062F8Medicaid
TXZ000062F8Medicaid