Individual provider Active NPI

Tarik Shaheen

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1265666911
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
Q2061 Issued in TX
Practice address
3500 Gaston Ave
Dallas, TX 75246-2088
Phone
(512) 838-4264
NPI assigned
May 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101254873 VA
Psychiatry Physician 2084P0800X MD60869375 WA
Psychiatry Physician 2084P0800X 63932 MN
Child & Adolescent Psychiatry Physician 2084P0804X MD60869375 WA
Child & Adolescent Psychiatry Physician 2084P0804X 0101254873 VA
Psychiatry Physician 2084P0800X MD175575 OR
Psychiatry Physician 2084P0800X 161-320 WI
Child & Adolescent Psychiatry Physician 2084P0804X Q2061 TX
Child & Adolescent Psychiatry Physician 2084P0804X 63932 MN
Child & Adolescent Psychiatry Physician 2084P0804X MD175575 OR
Child & Adolescent Psychiatry Physician 2084P0804X 161-320 WI
Psychiatry Physician 2084P0800X Q2061 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2088

Mailing address

807 West Ave
Austin, TX 78701-2207
Phone (512) 838-4264

Other practice location 1

1650 NW Naito Pkwy Ste 185
Portland, OR 97209-2535
Phone (512) 838-4264

Other practice location 2

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (612) 262-1220

Other practice location 3

2211 NE 139th St
Vancouver, WA 98686-2742
Phone (360) 487-1000

Other practice location 4

1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161-320WIMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1265666911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 WEST AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012207",
            "telephone_number": "512-838-4264",
            "fax_number": "512-838-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462088",
            "telephone_number": "512-838-4264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 NW Naito Pkwy Ste 185",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972092535",
            "country_code": "US",
            "telephone_number": "512-838-4264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4050 Coon Rapids Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332522",
            "country_code": "US",
            "telephone_number": "612-262-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2211 NE 139th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862742",
            "country_code": "US",
            "telephone_number": "360-487-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 E Division St",
            "address_purpose": "LOCATION",
            "city": "River Falls",
            "state": "WI",
            "postal_code": "540221571",
            "country_code": "US",
            "telephone_number": "715-307-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHEEN",
        "first_name": "TARIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101254873",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60869375",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "63932",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD60869375",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101254873",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD175575",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "161-320",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "Q2061",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "63932",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD175575",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "161-320",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q2061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.