Provider Demographics
NPI:1336504745
Name:SHAH, SYED ZUBAIRUDDIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:ZUBAIRUDDIN
Last Name:SHAH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5523 BARLEYCORN LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6225
Mailing Address - Country:US
Mailing Address - Phone:317-514-0106
Mailing Address - Fax:
Practice Address - Street 1:6630 FM 1463 RD., SUITE 400-A
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:832-437-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist