Healthcare Provider Details

I. General information

NPI: 1518124452
Provider Name (Legal Business Name): MEHA M SHAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 CENTRAL EXPY N SUITE 235
ALLEN TX
75013-6103
US

IV. Provider business mailing address

PO BOX 975341
DALLAS TX
75397-5341
US

V. Phone/Fax

Practice location:
  • Phone: 972-747-6042
  • Fax:
Mailing address:
  • Phone: 972-791-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0116017559
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN7348
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101251693
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: