Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | M2091 | TX |
N | 207PP0204X | Pediatric Emergency Physician | M2091 | TX |
N | 208000000X | Pediatrician | M2091 | TX |
NPI | 1780764118 |
---|---|
Provider Name | Monisha Shah |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 26/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100135YK00 | (02) | TX |
177319401 | (05) | TX |
177319406 | (05) | TX |
177319412 | (05) | TX |
177319413 | CSHCN (01) | TX |
1780764118 | TRICARE SOUTH (01) | TX |
8BE062 | BCBS OF TEXAS (01) | TX |
I46541 | (02) |