Provider Demographics
NPI:1083416549
Name:SHEIK MOHAIDEEN, SHAMATHKHAN
Entity type:Individual
Prefix:
First Name:SHAMATHKHAN
Middle Name:
Last Name:SHEIK MOHAIDEEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 PLEASANT VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-8225
Mailing Address - Country:US
Mailing Address - Phone:262-309-4122
Mailing Address - Fax:
Practice Address - Street 1:1661 PLEASANT VALLEY LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-8225
Practice Address - Country:US
Practice Address - Phone:262-309-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT137456225700000X
TX2187598225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty