Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | P8815 | TX |
N | 2080N0001X | Neonatal-Perinatal Doctor | 01069329A | IN |
Y | 2080N0001X | Neonatal-Perinatal Doctor | P8815 | TX |
NPI | 1144485640 |
---|---|
Provider Name | Dr. Syed K Shah |
First Address | Corpus Christi, TX 78414-2429 |
Second Address | Corpus Christi, TX 78414-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2008 |
Last Update Date | 23/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
094872102 | (05) | TX |
335870702 | CSHCN (01) | TX |