Provider Demographics
NPI:1992192272
Name:SHAH, ANITA (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11665 FUQUA ST STE C301
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-4632
Mailing Address - Country:US
Mailing Address - Phone:713-947-9509
Mailing Address - Fax:713-947-0609
Practice Address - Street 1:6624 FANNIN ST STE 2200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2334
Practice Address - Country:US
Practice Address - Phone:713-791-2648
Practice Address - Fax:713-947-0609
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS4867207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology