Individual provider Active NPI

Shams S.M. Tabrez, M.D.

  • Gastroenterology Physician
  • Willow Park, TX
National Provider Identifier
1215902184
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
T9989 Issued in TX
Practice address
130 Jimma Dr Unit a
Willow Park, TX 76087-1331
Phone
(817) 599-6222
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X T9989 TX Primary

Addresses

Primary practice location

130 Jimma Dr Unit a
Willow Park, TX 76087-1331

Mailing address

PO Box 206239
Dallas, TX 75320-6239
Phone (214) 424-2200

Other practice location 1

205 N Park Ave
Suite 106
Apopka, FL 32703-4102
Phone (407) 797-1179

Other identifiers 1

IdentifierTypeStateIssuer
E1745MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080620000544 FL Practitioner - Gastroenterology 6305917139 Reassigns benefits to 2 organizations
I20240917004068 TX Practitioner - Gastroenterology 6305917139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

130 Jimma Dr
Willow Park, TX 76087-1329
Phone (817) 363-1410

Hospital & facility affiliations

  • Texas Health Harris Methodist Hospital Azle Hospital, Azle, TX, CCN 450419
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Medical City Weatherford Hospital, Weatherford, TX, CCN 450203
  • Palo Pinto General Hospital Hospital, Mineral Wells, TX, CCN 450565

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy69
Upper gastrointestinal (GI) endoscopy for acid reflux55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T9989TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Sep 1, 2024 Accepting new patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Sep 1, 2024 Accepting new patients
Orlando Gastroenterology, P.a. Gastroenterology CurrentSince Jul 1, 2018 Accepting new patients
Sand Lake Cancer Center Past Accepting new patients

Locations

1507 S Hiawassee Rd
Ste 105
Orlando, FL 32835
Phone (407) 445-9224

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

130 Jimma Dr
Unit A
Willow Park, TX 76087
Phone (817) 363-1400

130 Jimma Dr
Willow Park, TX 76087
Phone (817) 363-1410

Interoperability endpoints

  • Direct secure messaging: stabrez618283@direct.shands.ufl.edu

Organizations & group practices 5

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 4

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1215902184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206239",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753206239",
            "telephone_number": "214-424-2200",
            "fax_number": "214-231-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 JIMMA DR UNIT A",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760871331",
            "telephone_number": "817-599-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N Park Ave",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Apopka",
            "state": "FL",
            "postal_code": "327034102",
            "country_code": "US",
            "telephone_number": "407-797-1179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABREZ",
        "first_name": "SHAMS",
        "middle_name": "S.M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "T9989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E1745",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Park, TX

Sources for this page

Verify at the official NPI Registry.