Provider Demographics
NPI:1053509620
Name:ANILA SHAH DDS PA
Entity Type:Organization
Organization Name:ANILA SHAH DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-473-7733
Mailing Address - Street 1:9829 MADELINE ALYSSA CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-4342
Mailing Address - Country:US
Mailing Address - Phone:713-661-3351
Mailing Address - Fax:713-473-8787
Practice Address - Street 1:320 SOUTHMORE AVE STE 312B
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1135
Practice Address - Country:US
Practice Address - Phone:713-473-7733
Practice Address - Fax:713-473-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty