Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125.059992 | IL |
N | 111NI0900X | Internist | 125.059992 | IL |
NPI | 1003101130 |
---|---|
Provider Name | Dr. Rohan Samir Shah |
First Address | Houston, TX 77054-3905 |
Second Address | Houston, TX 77054-3905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 03/12/2019 |