Provider Demographics
NPI:1992851182
Name:AFAF Z. SHAH MD, PA
Entity Type:Organization
Organization Name:AFAF Z. SHAH MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AFAF
Authorized Official - Middle Name:Z
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-200-5557
Mailing Address - Street 1:8840 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-5809
Mailing Address - Country:US
Mailing Address - Phone:832-200-5557
Mailing Address - Fax:713-686-7535
Practice Address - Street 1:15101 EAST FWY
Practice Address - Street 2:
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530-4104
Practice Address - Country:US
Practice Address - Phone:832-200-5557
Practice Address - Fax:713-686-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0885207Q00000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00269TOtherBLUE CROSS BLUE SHIELD
TXE77633Medicare UPIN
TX00269TMedicare ID - Type UnspecifiedGROUP NO.