Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | M1440 | TX |
Y | 207Q00000X | Family Doctor | M1440 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | M1440 | TX |
NPI | 1033132758 |
---|---|
Provider Name | Dr. Aman A Shah |
First Address | Dallas, TX 75284-4658 |
Second Address | Waco, TX 76712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178011602 | (05) | TX |
I41808 | (02) |