Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | R0128 | TX |
N | 207QA0505X | Family Doctor - Adult Medicine | 036129162 | IL |
NPI | 1033419551 |
---|---|
Provider Name | Dr. Chintalben D Shah |
First Address | San Antonio, TX 78251-4498 |
Second Address | San Antonio, TX 78251-4498 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2010 |
Last Update Date | 17/03/2018 |