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General NPI Number Information
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NPI Number | 1124699525
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Entity Type | Individual
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Provider Name | KEJAL SHAH MD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2021
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1631 11TH ST UNIT B
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4332
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Country | US
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Telephone | 940-263-3000
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Fax | 940-263-3018
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Provider Business Mailing Address
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Address Line | 1631 11TH ST UNIT B
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4332
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Country | US
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Telephone | 940-263-3000
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Fax | 940-263-3018
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V0159
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License Number State | TX
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