Provider Demographics
NPI:1316934862
Name:SHAH, NEEPA RAJNIKANT (MD)
Entity type:Individual
Prefix:DR
First Name:NEEPA
Middle Name:RAJNIKANT
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NEEPA
Other - Middle Name:RAJNIKANT
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4001 W 15TH ST STE 245
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5839
Mailing Address - Country:US
Mailing Address - Phone:972-596-5222
Mailing Address - Fax:972-596-5291
Practice Address - Street 1:4001 W 15TH ST STE 245
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5839
Practice Address - Country:US
Practice Address - Phone:972-596-5222
Practice Address - Fax:972-596-5291
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34040207R00000X
TXP4109207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX320202001Medicaid
TX320202001Medicaid
TX270869YL7AMedicare PIN
H34367Medicare UPIN