Provider Demographics
NPI:1326227703
Name:PARUL R SHAH, D.O., P.A.
Entity Type:Organization
Organization Name:PARUL R SHAH, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-499-5808
Mailing Address - Street 1:5201 HIGHWAY 6
Mailing Address - Street 2:SUITE 575
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4379
Mailing Address - Country:US
Mailing Address - Phone:281-499-4789
Mailing Address - Fax:
Practice Address - Street 1:5201 HIGHWAY 6
Practice Address - Street 2:SUITE 575
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4379
Practice Address - Country:US
Practice Address - Phone:281-499-4789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4239207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0054HKOtherBLUE CROSS BLUE SHIELD
TX0054HKOtherBLUE CROSS BLUE SHIELD