Provider Demographics
NPI:1235331513
Name:SHAH, NOSHEEN RIZVI (MD)
Entity Type:Individual
Prefix:
First Name:NOSHEEN
Middle Name:RIZVI
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 N BRITAIN RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2630
Practice Address - Country:US
Practice Address - Phone:214-266-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7616207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195837324Medicaid
TX8AM279OtherBCBS
TX195837320Medicaid
TX195837323Medicaid
TX195837306Medicaid
TX195837310Medicaid
TX195837316Medicaid
TX195837303Medicaid
TX195837305Medicaid
TX195837317Medicaid
TX195837301Medicaid
TX195837313Medicaid
TX195837314Medicaid
TX195837325Medicaid
TX195837302Medicaid
TX195837309Medicaid
TX195837315Medicaid
TX195837318Medicaid
TX195837307Medicaid
TX195837312Medicaid
TX195837322Medicaid
TX195837308Medicaid
TX195837311Medicaid
TX195837319Medicaid
TX195837321Medicaid
TX8L4278Medicare PIN