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Organization
SHUBHA P SHETTY MD PA
Active
Organization
SHUBHA P SHETTY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHUBHA PREMNATH SHETTY MD (MD)
(972) 904-7683
Entity
Organization
Contact information
Practice address
4502 RIVERSTONE BLVD, SUITE 1003, MISSOURI CITY, TX 77459-5204
(972) 904-7683
Mailing address
4502 RIVERSTONE BLVD, MISSOURI CITY, TX 77459-5204
(972) 904-7683
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N4096
TX
261QP2300X
Primary Care Clinic/Center
N4096
TX
Other
Enumeration date
07/12/2016
Last updated
08/08/2016
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