MEDICARE: BINA S SHAH FNP

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	363LF0000X	Family Nurse Practitioner	AP122417	TX

General Provider Information

NPI Number	:	1457602492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BINA S SHAH FNP

Provider Business Mailing Address
First Line	:	5508 AMPHORA AVE
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2548
Country	:	US
Telephone Number	:	469-347-0198
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 LEBANON RD
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-5150
Country	:	US
Telephone Number	:	972-624-8170
Fax Number	:

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

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	11/21/2024

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