Provider Demographics
NPI:1538115712
Name:SHAH, SYED ZAHID H
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:ZAHID H
Last Name:SHAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W. MCDERMOTT
Mailing Address - Street 2:STE B
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2700
Mailing Address - Country:US
Mailing Address - Phone:972-359-0000
Mailing Address - Fax:972-359-1000
Practice Address - Street 1:600 W. MCDERMOTT
Practice Address - Street 2:STE B
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2700
Practice Address - Country:US
Practice Address - Phone:972-359-0000
Practice Address - Fax:972-359-1000
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8485207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168126402Medicaid
TX168126402Medicaid
G51516Medicare UPIN