MEDICARE: DR. PRATAP C SHAH M.D., F.A.C.S.

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	208800000X	Urology Physician	168768	NY

General Provider Information

NPI Number	:	1871505271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRATAP C SHAH M.D., F.A.C.S.

Provider Business Mailing Address
First Line	:	4719 LLANO LOOP
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7084
Country	:	US
Telephone Number	:	254-421-4213
Fax Number	:	832-905-5941

Provider Business Practice Location Address
First Line	:	4719 LLANO LOOP
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7084
Country	:	US
Telephone Number	:	254-421-4213
Fax Number	:	832-905-5941

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

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	07/21/2022

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