Provider Demographics
NPI:1588382626
Name:SHAH, KRISHABEN (MS, PT)
Entity type:Individual
Prefix:
First Name:KRISHABEN
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18910 BAILEY OAKS LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3160
Mailing Address - Country:US
Mailing Address - Phone:832-469-8297
Mailing Address - Fax:
Practice Address - Street 1:8955 HIGHWAY 6 N STE 190
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2321
Practice Address - Country:US
Practice Address - Phone:832-593-8600
Practice Address - Fax:832-593-8601
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1363452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist