Healthcare Provider Details

I. General information

NPI: 1538139647
Provider Name (Legal Business Name): PARIN P SHAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12302 BEND CREEK LN
PEARLAND TX
77584-9727
US

IV. Provider business mailing address

12302 BEND CREEK LN
PEARLAND TX
77584-9727
US

V. Phone/Fax

Practice location:
  • Phone: 773-562-0326
  • Fax:
Mailing address:
  • Phone: 773-562-0326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberM2092
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: