Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | H9712 | TX |
NPI | 1710981113 |
---|---|
Provider Name | Pankaj K Shah |
First Address | Houston, TX 77074-2932 |
Second Address | Houston, TX 77074-2932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 24/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
098556602 | (05) | TX |
098556604 | (05) | TX |
098556605 | (05) | TX |
D34189 | (02) | TX |