Provider Demographics
NPI:1013172048
Name:DR. AMIT SHAH & ASSOCIATES
Entity Type:Organization
Organization Name:DR. AMIT SHAH & ASSOCIATES
Other - Org Name:TSO KATY RANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-392-4010
Mailing Address - Street 1:24441 KATY FWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1376
Mailing Address - Country:US
Mailing Address - Phone:281-392-4010
Mailing Address - Fax:
Practice Address - Street 1:24441 KATY FWY
Practice Address - Street 2:SUITE 300
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1376
Practice Address - Country:US
Practice Address - Phone:281-392-4010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6256TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347524OtherMEDICARE PTAN