Provider Demographics
NPI:1831224781
Name:SHAH MEDICAL ENTERPRISES INC
Entity type:Organization
Organization Name:SHAH MEDICAL ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUNKUMAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-540-2273
Mailing Address - Street 1:9810 FM 1960 WEST BYPASS
Mailing Address - Street 2:STE# 115
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3573
Mailing Address - Country:US
Mailing Address - Phone:281-540-2273
Mailing Address - Fax:
Practice Address - Street 1:9810 FM 1960 BYPASS RD W
Practice Address - Street 2:STE# 115
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3502
Practice Address - Country:US
Practice Address - Phone:281-540-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6323174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00LE12Medicare ID - Type Unspecified
TXC21643Medicare UPIN