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General NPI Number Information
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NPI Number | 1518235712
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Entity Type | Individual
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Provider Name | PRINA SHAH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 5016 S US HIGHWAY 75 TEXOMA MEDICAL CENTER
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City | DENISON
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State | TX
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Zip | 75020-4584
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Country | US
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Telephone | 903-416-2066
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Fax |
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Provider Business Mailing Address
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Address Line | 5295 N TRAVIS ST APT 2306
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City | KNOLLWOOD
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State | TX
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Zip | 75092-4095
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Country | US
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Telephone | 515-554-4838
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 49647
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051292682
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License Number State | IL
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