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General NPI Number Information
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NPI Number | 1831497528
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Entity Type | Individual
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Provider Name | PROF. NIKITA NIKUNJ SHAH
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Gender | Female
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Dates
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Enumeration Date | 03/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 5990 AIRLINE DR SUITE 160
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City | HOUSTON
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State | TX
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Zip | 77076-4233
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Country | US
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Telephone | 713-695-9947
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Fax | 713-699-6218
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Provider Business Mailing Address
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Address Line | 5990 AIRLINE DR SUITE160
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City | HOUSTON
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State | TX
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Zip | 77076-4233
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Country | US
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Telephone | 713-695-9947
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Fax | 713-699-6218
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA07022
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License Number State | TX
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