Provider Demographics
NPI:1407937592
Name:SHAH, FARAH AFTAB (MD)
Entity Type:Individual
Prefix:DR
First Name:FARAH
Middle Name:AFTAB
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FARAH
Other - Middle Name:
Other - Last Name:AFTAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2900 N INTERSTATE 35 STE 118
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-5143
Mailing Address - Country:US
Mailing Address - Phone:940-380-8100
Mailing Address - Fax:
Practice Address - Street 1:2900 N INTERSTATE 35 STE 118
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-5143
Practice Address - Country:US
Practice Address - Phone:940-380-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119118104Medicaid
TX119118104Medicaid