Provider Demographics
NPI:1790786549
Name:SHPATS, INNA (MD PA)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:SHPATS
Suffix:
Gender:F
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37269
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77237-7269
Mailing Address - Country:US
Mailing Address - Phone:281-265-2272
Mailing Address - Fax:281-491-4181
Practice Address - Street 1:16659 SOUTHWEST FWY
Practice Address - Street 2:SUITE 301
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2373
Practice Address - Country:US
Practice Address - Phone:281-265-2272
Practice Address - Fax:281-491-4181
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4849207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166510101Medicaid
TX8C0864Medicare PIN
E79994Medicare UPIN