Provider Demographics
NPI:1780979484
Name:SHAH, MEGHA (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGHA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201
Mailing Address - Country:US
Mailing Address - Phone:940-898-8780
Mailing Address - Fax:940-898-8648
Practice Address - Street 1:2850 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-1601
Practice Address - Country:US
Practice Address - Phone:940-898-8780
Practice Address - Fax:940-898-8648
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5032037289183500000X
TX56539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780979484Medicaid