Provider Demographics
NPI:1508865866
Name:SHAH, ALPESH R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALPESH
Middle Name:R
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 CULLEN BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3921
Mailing Address - Country:US
Mailing Address - Phone:713-441-9909
Mailing Address - Fax:281-485-7305
Practice Address - Street 1:2950 CULLEN BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3921
Practice Address - Country:US
Practice Address - Phone:713-441-9909
Practice Address - Fax:281-485-7305
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8835174400000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046623701Medicaid
TX0466237-01Medicaid
TX8FH199OtherBLUE CROSS BLUE SHIELD
TX046623703Medicaid
TX8FH199OtherBLUE CROSS BLUE SHIELD
H22270Medicare UPIN
TXH22270Medicare UPIN
TX046623701Medicaid