Provider Demographics
NPI:1871675074
Name:SHAH, URMESH S (MD)
Entity Type:Individual
Prefix:
First Name:URMESH
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 1:4201 BROOK SPRING DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-4968
Mailing Address - Country:US
Mailing Address - Phone:214-266-1450
Mailing Address - Fax:214-266-1455
Practice Address - Street 1:4201 BROOK SPRING DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-4968
Practice Address - Country:US
Practice Address - Phone:214-266-1450
Practice Address - Fax:214-266-1455
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0193208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146942100OtherFIRSTCARE PIN
TX1640408OtherFIRSTHEALTH PIN
TXSHAUG27037OtherCCHIP PIN
TX126582903Medicaid
TX140442825Medicaid
1750369203OtherGRP NPI NUMBER
TX5180520OtherAETNA PIN
TX89990YOtherBCBSTX IND PIN
TX126582905Medicaid
TX018424401Medicaid
TX140442824Medicaid
TX00U87ZOtherBCBSTX GRP PIN
TX1392645OtherUHC PIN
TX6585914OtherCIGNA PIN
1750369203OtherGRP NPI NUMBER
TXSHAUG27037OtherCCHIP PIN
TX126582903Medicaid