Provider Demographics
NPI:1144890021
Name:SHADPOUR, SHEKOUFEH (APRN-CNP)
Entity type:Individual
Prefix:MS
First Name:SHEKOUFEH
Middle Name:
Last Name:SHADPOUR
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 N SAM HOUSTON PKWY E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-2900
Mailing Address - Country:US
Mailing Address - Phone:512-797-4489
Mailing Address - Fax:
Practice Address - Street 1:8000 N SAM HOUSTON PKWY E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-2900
Practice Address - Country:US
Practice Address - Phone:512-797-4489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023630363L00000X
TX1008990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner