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General NPI Number Information
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NPI Number | 1851537906
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Entity Type | Organization
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Legal Business Name | SHAH EYE CENTER, P.A.
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Dates
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Enumeration Date | 12/19/2008
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Last Update Date | 12/24/2008
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Provider Practice Location Address
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Address Line | 8607 MCPHERSON RD STE 102
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City | LAREDO
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State | TX
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Zip | 78045-6382
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Country | US
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Telephone | 956-753-0202
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Fax | 956-753-0204
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Provider Business Mailing Address
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Address Line | 2025 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3222
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Country | US
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Telephone | 956-583-0202
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Fax | 956-583-0200
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Authorized Official
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Title or Position | OWNER
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Name | DR. PANKAJKUMAR G SHAH
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Credential | M.D.
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Telephone | 956-583-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | J9336
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License Number State | TX
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