Provider Demographics
NPI:1467147793
Name:AMI SHAH VIRA MD PLLC
Entity Type:Organization
Organization Name:AMI SHAH VIRA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-767-5023
Mailing Address - Street 1:10012 LAVON BND
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4169
Mailing Address - Country:US
Mailing Address - Phone:512-553-9545
Mailing Address - Fax:484-968-8082
Practice Address - Street 1:10012 LAVON BND
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-4169
Practice Address - Country:US
Practice Address - Phone:512-553-9545
Practice Address - Fax:484-968-8082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty