Provider Demographics
NPI:1730354945
Name:SHAFII, ALEXIS EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:EDWARD
Last Name:SHAFII
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 1:6620 MAIN ST STE 1325
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2332
Mailing Address - Country:US
Mailing Address - Phone:713-798-5700
Mailing Address - Fax:
Practice Address - Street 1:6620 MAIN ST STE 1325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2332
Practice Address - Country:US
Practice Address - Phone:713-798-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL93623208600000X
OH35089747208600000X
TXP3074208600000X, 208G00000X
KY48259208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3050759-01Medicaid
TX3050759-02Medicaid
TXTXB158667Medicare PIN
TX298582YMNTMedicare PIN
TX298627YKTPMedicare PIN