Basic Information
| Provider Information | |||||||||
| NPI: | 1265696991 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONCOLOGY AND HEMATOLOGY CONSULTANTS OF HOUSTON PA | ||||||||
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| OtherOrganizationName: | NABEEL K SHALAN MD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 996 | ||||||||
| Address2: | |||||||||
| City: | HAYDEN | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838350996 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2086644026 | ||||||||
| FaxNumber: | 2086644840 | ||||||||
| Practice Location | |||||||||
| Address1: | 7500 BEECHNUT ST | ||||||||
| Address2: | 265 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770744335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139811500 | ||||||||
| FaxNumber: | 7139811504 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2008 | ||||||||
| LastUpdateDate: | 05/26/2009 | ||||||||
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| AuthorizedOfficialLastName: | SHALAN | ||||||||
| AuthorizedOfficialFirstName: | NABEEL | ||||||||
| AuthorizedOfficialMiddleName: | KAMAL | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7139811500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | L8504 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 198233201 | 05 | TX | MEDICAID |