Provider Demographics
NPI:1184398570
Name:SHETH, PRIYANKA RAJESH
Entity type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:RAJESH
Last Name:SHETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PRIYANKA
Other - Middle Name:RAJESH
Other - Last Name:SHETH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11315 MELLINGSHAW LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1855
Mailing Address - Country:US
Mailing Address - Phone:713-569-9205
Mailing Address - Fax:
Practice Address - Street 1:8021 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5200
Practice Address - Country:US
Practice Address - Phone:713-774-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1233060225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist