Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A123804 | CA |
N | 111NI0900X | Internist | A123804 | CA |
Y | 207R00000X | Internist | Q6034 | TX |
Y | 111NI0900X | Internist | Q6034 | TX |
NPI | 1003134974 |
---|---|
Provider Name | Ruby Jain Shah |
First Address | Plano, TX 75024-7102 |
Second Address | Plano, TX 75093-4742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2010 |
Last Update Date | 02/04/2019 |