Provider Demographics
NPI:1265727184
Name:SHAH, RAJAVI (MD)
Entity type:Individual
Prefix:DR
First Name:RAJAVI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WOODLAWN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3987
Mailing Address - Country:US
Mailing Address - Phone:832-783-1079
Mailing Address - Fax:
Practice Address - Street 1:107 WOODLAWN DR STE 101
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546
Practice Address - Country:US
Practice Address - Phone:832-783-1079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53960207R00000X
TXQ6570207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine