Provider Demographics
NPI:1306903265
Name:SHAH, VIREN N (MD)
Entity type:Individual
Prefix:
First Name:VIREN
Middle Name:N
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1235 LAKE POINTE PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3389
Mailing Address - Country:US
Mailing Address - Phone:281-980-2233
Mailing Address - Fax:281-980-2220
Practice Address - Street 1:1235 LAKEPOINT PKWY SUITE 101
Practice Address - Street 2:
Practice Address - City:SUGARLAND
Practice Address - State:FORT BEND
Practice Address - Zip Code:77478
Practice Address - Country:UM
Practice Address - Phone:281-980-2233
Practice Address - Fax:281-980-2220
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144074501Medicaid
TX00393QMedicare ID - Type Unspecified
TX144074501Medicaid