MEDICARE: SUNIL K SHAH O.T.R/L, CHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XH1200X	Hand Occupational Therapist	108997	TX

General Provider Information

NPI Number	:	1083716252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNIL K SHAH O.T.R/L, CHT

Provider Business Mailing Address
First Line	:	832 ROYAL CREST CT
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-4915
Country	:	US
Telephone Number	:	562-965-4220
Fax Number	:

Provider Business Practice Location Address
First Line	:	832 ROYAL CREST CT
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-4915
Country	:	US
Telephone Number	:	562-965-4220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	01/10/2021

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