Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | J5013 | TX |
NPI | 1124246491 |
---|---|
Provider Name | Indu Ramesh Shah |
First Address | Missouri City, TX 77459 |
Second Address | Houston, TX 77077-1733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |