Individual provider Active NPI

Shamaila Haris, MD

  • Family Medicine Physician
  • Huntsville, TX
National Provider Identifier
1194037010
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q7386 Issued in TX
Practice address
125 Medical Park LN Ste C
Huntsville, TX 77340-4957
Phone
(936) 291-3219
Fax
(936) 291-7206
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q7386 TX Primary

Addresses

Primary practice location

125 Medical Park LN Ste C
Huntsville, TX 77340-4957

Mailing address

PO Box 4001
Huntsville, TX 77342-4001
Phone (936) 291-3219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405001704 TX Practitioner - Family Practice 0345507877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Community Hospital, Inc.Group PAC ID 6103255732, 12 clinicians

Practice addresses (Care Compare)

125 Medical Park LN
Huntsville, TX 77340-4957

Hospital & facility affiliations

  • Huntsville Memorial Hospital Hospital, Huntsville, TX, CCN 450347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Community Hospital, Inc. Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Huntsville Community Hospital, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Huntsville Community Hospital, Inc. Past Accepting new patients

Locations

125 Medical Park Ln
Ste C
Huntsville, TX 77340
Phone (936) 291-3219

125 Medical Park Ln
Ste D
Huntsville, TX 77340
Phone (936) 400-7221

Interoperability endpoints

  • Direct secure messaging: shamaila.haris.1@13218.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1194037010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4001",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773424001",
            "telephone_number": "936-291-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MEDICAL PARK LN STE C",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404957",
            "telephone_number": "936-291-3219",
            "fax_number": "936-291-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIS",
        "first_name": "SHAMAILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q7386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, TX

Sources for this page

Verify at the official NPI Registry.