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General NPI Number Information
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NPI Number | 1053509620
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Entity Type | Organization
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Legal Business Name | ANILA SHAH DDS PA
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 320 SOUTHMORE AVE STE 312B
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City | PASADENA
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State | TX
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Zip | 77502-1135
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Country | US
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Telephone | 713-473-7733
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Fax | 713-473-8787
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Provider Business Mailing Address
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Address Line | 9829 MADELINE ALYSSA CT
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City | HOUSTON
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State | TX
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Zip | 77025-4342
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Country | US
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Telephone | 713-661-3351
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Fax | 713-473-8787
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANILA SHAH
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Credential |
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Telephone | 713-473-7733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20959
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License Number State | TX
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