Provider Demographics
NPI:1861591927
Name:TABIBI, SHAHRZAD (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHRZAD
Middle Name:
Last Name:TABIBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2550 SAMARITAN DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1170
Mailing Address - Country:US
Mailing Address - Phone:575-386-5548
Mailing Address - Fax:575-652-5319
Practice Address - Street 1:2550 SAMARITAN DR STE 201
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1170
Practice Address - Country:US
Practice Address - Phone:575-386-5548
Practice Address - Fax:575-652-5319
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2018-0662207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology