Provider Demographics
NPI:1124375761
Name:SHAH, AJITA R (MD)
Entity Type:Individual
Prefix:DR
First Name:AJITA
Middle Name:R
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:900 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2210
Mailing Address - Country:US
Mailing Address - Phone:512-947-1897
Mailing Address - Fax:512-487-5376
Practice Address - Street 1:900 WEST AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2210
Practice Address - Country:US
Practice Address - Phone:512-947-1897
Practice Address - Fax:512-487-5376
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP7205207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine