SHADAN MANSOOR (NPI# 1679523088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679523088 |
| Entity Type | Individual |
| Full Name | SHADAN MANSOOR |
| Credential | M.D. |
| Practice Address |
11805 South Fwy Ste 201 Burleson TX 76028-7220 |
| Mailing Address |
Po Box 164009 Fort Worth TX 76161-4009 |
| Practice Telephone | 8175515312 |
| Mailing Telephone | 8177597000 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
M1226 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1736241-01 | 05 | |
| TX | 1736241-02 | 05 | |
| TX | BCBS | 8M2993 | 01 |
| Street Address |
11805 SOUTH FWY STE 201 |
| City | BURLESON |
| State | TX |
| Zip Code | 76028-7220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790729663 | Laurie A Hill | Physician Assistant | 11805 South Fwy Ste 201, Burleson, TX 76028-7220 | 2006-06-15 |
| 1881647493 | Vinaya Potluri | Internal Medicine | 11805 South Fwy Ste 201, Burleson, TX 76028-7220 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679104657 | Ballard Family Dentistry In Burleson | Dentist | 2701 Sw Wilshire Blvd, Burleson, TX 76028 | 2020-01-29 |
| 1013567205 | Amy Burden | Family Medicine | 240 E Renfro St Ste 203, Burleson, TX 76028 | 2019-09-19 |
| 1962985903 | Bobbie Jo Deweese | Registered Nurse | 279 W Hidden Creek Pkwy Ste 1209, Burleson, TX 76028 | 2018-09-14 |
| 1154803096 | Martha Jepchirchir | Registered Nurse | 1084 Meadow Scape Dr, Burleson, TX 76028 | 2018-09-06 |
| 1407334022 | Catherine Cornelia Wilson | Registered Nurse | 12500 South Fwy Ste 100, Burleson, TX 76028 | 2018-08-06 |
| 1174001911 | Amanda Kaye Contino | Registered Nurse | 120 Ne Wilshire Blvd, Burleson, TX 76028 | 2018-08-03 |
| 1275019671 | Lacey Paulett Anderson | Speech-Language Pathologist | 1101 Whispering Spring Ct, Burleson, TX 76028 | 2018-07-18 |
| 1720572647 | Keith Anderson Orthodontics Pllc | Dentist | 310 Nw John Jones Dr, Suite 108, Burleson, TX 76028 | 2018-06-15 |
| 1033602537 | Justin Randal Sanders | Nurse Practitioner | 924 County Road 914, Burleson, TX 76028 | 2018-06-08 |
| 1861992695 | Taylor Henry | Family Medicine | 739 Tanglewood Drive, Burleson, TX 76028 | 2018-02-19 |
| Find all providers in zip 76028 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881647493 | Vinaya Potluri | Internal Medicine | 11805 South Fwy Ste 201, Burleson, TX 76028-7220 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205399961 | Christus Health Ark-la-tex | Internal Medicine | 5002 Cowhorn Creek Rd Ste 3205, Texarkana, TX 75503-9766 | 2019-04-10 |
| 1861958704 | Thi of Texas At Samaritan Hospice LLC | Internal Medicine | 12001 N Central Expy Ste 550, Dallas, TX 75243-3943 | 2019-02-15 |
| 1417485822 | Ahmad Ghorab | Internal Medicine | 1515 Holcombe Blvd #1445, Houston, TX 77030 | 2017-05-30 |
| 1063952943 | Irfan Jawed Md Pllc | Internal Medicine | 4102 Woodlawn Avenue, Ste 160, Pasadena, TX 77504 | 2017-02-27 |
| 1366981615 | Houston Cancer Treatment Centers Pa. | Internal Medicine | 4102 Woodlawn Ave Ste 160, Pasadena, TX 77504-1922 | 2017-02-20 |
| 1508222720 | Maurizio Bendandi | Internal Medicine | 6722 Mimosa Ln, Dallas, TX 75230-5214 | 2016-01-04 |
| 1245642073 | Juan Francisco Garza | Internal Medicine | 3333 Bayshore Blvd Ste 320, Pasadena, TX 77504-1950 | 2014-05-28 |
| 1124463211 | Oluchi Oke | Internal Medicine | 1515 Holcombe Blvd Unit 463, Division of Cancer Medicine, Houston, TX 77030-4000 | 2013-05-03 |
| 1710229323 | Adaeze Nwosu- Iheme | Internal Medicine | 2700 Citizens Plz Ste 200, Victoria, TX 77901-5756 | 2013-03-21 |
| 1144570599 | Gummadi & Desai LLC | Internal Medicine | 2717 Michael Angelo Ste 302, Edinburg, TX 78539-1409 | 2012-09-13 |
| Find all providers with the same taxonomy | ||||
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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.