Healthcare Provider Details

I. General information

NPI: 1316375082
Provider Name (Legal Business Name): ALI SHAH EMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONGRESS ST
HOUSTON TX
77002-1956
US

IV. Provider business mailing address

1200 CONGRESS ST
HOUSTON TX
77002-1956
US

V. Phone/Fax

Practice location:
  • Phone: 713-222-4212
  • Fax: 713-222-4247
Mailing address:
  • Phone: 713-222-4212
  • Fax: 713-222-4247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number146972
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: