Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | 1205909 |
NPI | 1124380787 |
---|---|
Provider Name | Prachi Shah |
First Address | Houston, TX 77034-5414 |
Second Address | Houston, TX 77034-1110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 13/11/2013 |