MEDICARE: PRAPTI SHAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	1130190	TX

General Provider Information

NPI Number	:	1770363905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRAPTI SHAH

Provider Business Mailing Address
First Line	:	9609 MARLIVE LN UNIT A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-4833
Country	:	US
Telephone Number	:	469-644-6195
Fax Number	:

Provider Business Practice Location Address
First Line	:	9609 MARLIVE LN UNIT A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-4833
Country	:	US
Telephone Number	:	469-644-6195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	10/04/2023

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Directions to “ PRAPTI SHAH ” Practice Location

Language	Start Address	Practice Location

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