Provider Demographics
NPI:1285722553
Name:SHAH, PARUL R (DO)
Entity type:Individual
Prefix:DR
First Name:PARUL
Middle Name:R
Last Name:SHAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 RIVERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4092
Mailing Address - Country:US
Mailing Address - Phone:281-499-5808
Mailing Address - Fax:
Practice Address - Street 1:5201 HIGHWAY 6 # 575
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4379
Practice Address - Country:US
Practice Address - Phone:281-499-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4239207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044923304Medicaid
TX044923304Medicaid
TX8287B0Medicare PIN