Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1151327 | TX |
NPI | 1003185786 |
---|---|
Provider Name | Neha Shah |
First Address | San Antonio, TX 78258-4510 |
Second Address | San Antonio, TX 78240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2011 |
Last Update Date | 12/07/2018 |