Provider Demographics
NPI:1144401381
Name:ANJANA N. SHAH, M.D. P.A.
Entity Type:Organization
Organization Name:ANJANA N. SHAH, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-866-9187
Mailing Address - Street 1:PO BOX 90430
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77290-0430
Mailing Address - Country:US
Mailing Address - Phone:281-866-9187
Mailing Address - Fax:281-893-3154
Practice Address - Street 1:5501 LOUETTA RD
Practice Address - Street 2:#D
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7868
Practice Address - Country:US
Practice Address - Phone:281-866-9187
Practice Address - Fax:281-893-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136553807Medicaid
TX00715XMedicare PIN
TX00398JMedicare PIN