Provider Demographics
NPI:1740533017
Name:SHAH, UTSAVI (MD)
Entity type:Individual
Prefix:MS
First Name:UTSAVI
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 1:16651 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2347
Mailing Address - Country:US
Mailing Address - Phone:713-981-2457
Mailing Address - Fax:
Practice Address - Street 1:16651 SOUTHWEST FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2345
Practice Address - Country:US
Practice Address - Phone:832-826-7315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8635207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX389394901Medicaid