Healthcare Provider Details
I. General information
NPI: 1255395000
Provider Name (Legal Business Name): TORAL D SHAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/17/2006
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11111 RESEARCH BLVD STE 230
AUSTIN TX
78759-5791
US
IV. Provider business mailing address
2423 WILLIAMS DR STE 107
GEORGETOWN TX
78628-3269
US
V. Phone/Fax
- Phone: 877-800-5722
- Fax: 512-605-6396
- Phone: 877-800-5722
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | K8836 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | K8836 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | K8836 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: