ALIREZA ALLEN SHAKOURI (NPI# 1366652208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366652208 |
| Entity Type | Individual |
| Full Name | ALIREZA ALLEN SHAKOURI |
| Credential | MD |
| Practice Address |
900 E Southlake Blvd Ste 300 Southlake TX 76092-6375 |
| Practice Telephone | 8174210770 |
| Practice Fax Number | 8174248431 |
| Mailing Telephone | 8174210770 |
| Mailing Fax Number | 8174248431 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2016-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | N2294 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INSTITUTIONAL PERMIT | BP1-0026163 | 01 |
| Street Address |
900 E SOUTHLAKE BLVD STE 300 |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-6375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568545739 | Texas Regional Asthma & Allergy Center | Specialist | 900 E Southlake Blvd, Ste 300, Southlake, TX 76092-6375 | 2006-10-23 |
| 1144789934 | Caitlin Elizabeth Pedigo | Registered Nurse | 900 E Southlake Blvd, Southlake, TX 76092-6375 | 2019-03-19 |
| 1346646528 | Destination Health | Family Medicine | 900 E Southlake Blvd, Suite 200, Southlake, TX 76092-6375 | 2014-11-14 |
| 1922329465 | Sharon Seth | Allergy & Immunology | 900 E Southlake Blvd, Suite 300, Southlake, TX 76092-6375 | 2010-06-18 |
| 1255519344 | Southlake Plastic Surgery | Oral & Maxillofacial Surgery | 900 E Southlake Blvd, Ste 100, Southlake, TX 76092-6375 | 2008-01-31 |
| 1285787085 | Robin Annette Hall | Family Medicine | 900 E Southlake Blvd, Suite 200, Southlake, TX 76092-6375 | 2007-01-18 |
| 1639255896 | Rene Albert Leon | Specialist | 900 E Southlake Blvd, Ste 300, Southlake, TX 76092-6375 | 2006-10-31 |
| 1255414272 | Mark E Mason | Oral & Maxillofacial Surgery | 900 E Southlake Blvd, Ste 100, Southlake, TX 76092-6375 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114343431 | Robin Putnam | Specialist | 2425 E Southlake Blvd Ste 100, Southlake, TX 76092-6675 | 2014-03-11 |
| 1811010952 | Clifton L. Cox II M D P A | Specialist | 300 S. Nolen Dr., Suite 100, Southlake, TX 76092 | 2007-04-06 |
| 1568545739 | Texas Regional Asthma & Allergy Center | Specialist | 900 E Southlake Blvd, Ste 300, Southlake, TX 76092-6375 | 2006-10-23 |
| 1487735999 | Richard A Mayse | Specialist | 900 East Southlake Blvd., Ste 300, Southlake, TX 76092 | 2006-10-18 |
| 1215964473 | Angela G Bowers | Specialist | 1170 N Carroll Ave, Southlake, TX 76092-5306 | 2006-06-26 |
| 1285672519 | Carolyn J Woods | Specialist | 2140 E Southlake Blvd # L309, Southlake, TX 76092-6516 | 2006-06-02 |
| 1518948728 | James D Gonzales | Specialist | 515 W Southlake Blvd, Ste. 100, Southlake, TX 76092-6172 | 2005-11-07 |
| 1710980545 | David E Kosmoski | Specialist | 431 E State Highway 114, Suite 450, Southlake, TX 76092-4412 | 2005-05-24 |
| 1588213979 | Frontier In Healthcare | Specialist | 2805 Johnson Rd, Southlake, TX 76092-5619 | 2019-09-09 |
| 1033620976 | Voyage Monitoring, Pllc | Specialist | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2017-10-18 |
| Find all providers in SOUTHLAKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.