Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 32429 | TX |
NPI | 1013468529 |
---|---|
Provider Name | Dr. Karnik Shah |
First Address | Austin, TX 78741-1314 |
Second Address | Irving, TX 75038-3029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2016 |
Last Update Date | 28/05/2021 |