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General NPI Number Information
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NPI Number | 1205968757
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Entity Type | Individual
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Provider Name | NEERAJ B. SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/11/2007
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 305 FERGUSON DR
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City | AUSTIN
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State | TX
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Zip | 78753-3006
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Country | US
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Telephone | 512-814-5215
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Fax | 512-628-3277
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Provider Business Mailing Address
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Address Line | 1620 E RIVERSIDE DR APT 74214
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City | AUSTIN
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State | TX
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Zip | 78741-0068
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Country | US
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Telephone | 512-814-5215
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Fax | 512-628-3277
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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 | A96977
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N1889
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License Number State | TX
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