Individual ProviderShams MerchantNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address903 W Martin St, San Antonio, TX 78207(210) 358-9887PECOS EnrollmentBased on the most recent information from CMS, provider Shams Merchant is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1356849079Provider TypeIndividualFull NameMerchant, ShamsCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date1/28/2018Last Updated2/6/2019Contact InformationPractice LocationPractice Address903 W Martin St, San Antonio, TX 78207Phone(210) 358-9887Fax(210) 358-5840Mailing LocationMailing Address903 W Martin St, San Antonio, TX 78207-0903Phone(210) 358-9887Fax(210) 358-5840Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense363LF0000XTexasProvider IdentifiersIDDescriptionIssuerID392318702DescriptionOtherIssuerCSHCNTexasID392318701DescriptionMedicaidIssuerUnlistedTexasID74-2712740DescriptionMedicaidIssuerUnlistedTexas