Provider Demographics
NPI:1548260029
Name:UDDIN, SHAKEEL (MD)
Entity type:Individual
Prefix:
First Name:SHAKEEL
Middle Name:
Last Name:UDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 CHESTNUT RIDGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2023
Mailing Address - Country:US
Mailing Address - Phone:281-358-1950
Mailing Address - Fax:281-358-1923
Practice Address - Street 1:2627 CHESTNUT RIDGE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2023
Practice Address - Country:US
Practice Address - Phone:281-358-1950
Practice Address - Fax:281-358-1923
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3253207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060042469OtherRR MEDICARE
TXF94690Medicare UPIN