Provider Demographics
NPI:1770555682
Name:SHAH, BHADRESH B (MD)
Entity type:Individual
Prefix:
First Name:BHADRESH
Middle Name:B
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:4780 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3162
Mailing Address - Country:US
Mailing Address - Phone:281-242-2444
Mailing Address - Fax:281-242-2448
Practice Address - Street 1:4780 SWEETWATER BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3162
Practice Address - Country:US
Practice Address - Phone:281-242-2444
Practice Address - Fax:281-242-2448
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2008-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK1924207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096702803Medicaid
TX8P6981OtherBCBSTX
TX096702803Medicaid
TX8B9195Medicare PIN