Provider Demographics
NPI:1699020727
Name:SHAH, JAECEL O (MD)
Entity Type:Individual
Prefix:DR
First Name:JAECEL
Middle Name:O
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10740 N GESSNER DR. STE. 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:281-890-8908
Practice Address - Street 1:1501 RIVER POINTE DR STE 120
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2860
Practice Address - Country:US
Practice Address - Phone:936-539-4700
Practice Address - Fax:936-539-6618
Is Sole Proprietor?:No
Enumeration Date:2012-07-15
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR1870207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology