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General NPI Number Information
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NPI Number | 1275690232
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Entity Type | Organization
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Legal Business Name | I. H. SHAH, M.D. AND S. HASAN, M.D. AND ASSOCIATES
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 4004 MEDICAL PARKWAY
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City | GREENVILLE
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State | TX
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Zip | 75401
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Country | US
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Telephone | 903-455-4414
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Fax | 903-455-1944
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Provider Business Mailing Address
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Address Line | 4004 MEDICAL PARKWAY
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City | GREENVILLE
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State | TX
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Zip | 75401
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Country | US
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Telephone | 903-455-4414
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Fax | 903-455-1944
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Authorized Official
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Title or Position | GROUP PRACTITIONER GENERAL SURGEON
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Name | IQTIDAR U H SHAH
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Credential | MD
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Telephone | 903-408-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | E0365
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License Number State | TX
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