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General NPI Number Information
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NPI Number | 1184689937
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Entity Type | Individual
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Provider Name | DEEPA M SHAH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 2400 CEDAR BEND DR
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City | AUSTIN
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State | TX
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Zip | 78758-5378
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Country | US
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Telephone | 512-901-4016
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Fax | 512-901-3857
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Provider Business Mailing Address
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Address Line | 12221 N MOPAC EXPY
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-901-4937
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Fax | 512-901-3945
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | L0586
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | L0586
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L0586
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License Number State | TX
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