Provider Demographics
NPI:1548571748
Name:SHAH, SHENIL S (MD)
Entity Type:Individual
Prefix:
First Name:SHENIL
Middle Name:S
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 1:3600 W PARMER LN STE 160
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-4124
Mailing Address - Country:US
Mailing Address - Phone:512-977-0123
Mailing Address - Fax:
Practice Address - Street 1:3600 W PARMER LN STE 160
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-4124
Practice Address - Country:US
Practice Address - Phone:512-977-0123
Practice Address - Fax:512-977-0126
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5566207RC0200X, 207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine