Provider Demographics
NPI:1225224157
Name:SHAH, JINAL (MD)
Entity type:Individual
Prefix:
First Name:JINAL
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:16605 SOUTHWEST FREEWAY
Mailing Address - Street 2:MOB 3, SUITE 600
Mailing Address - City:SUGARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3666
Mailing Address - Country:US
Mailing Address - Phone:281-274-7595
Mailing Address - Fax:601-200-5929
Practice Address - Street 1:16605 SOUTHWEST FREEWAY
Practice Address - Street 2:MOB 3, SUITE 600
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3666
Practice Address - Country:US
Practice Address - Phone:281-274-7595
Practice Address - Fax:601-200-5929
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2022-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS211512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03470301Medicaid
MS266786YJ9XMedicare PIN