Individual
MS. DEEPA M SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2400 CEDAR BEND DR, AUSTIN, TX 78758-5378
(512) 901-4016
(512) 901-3857
Mailing address
12221 N MOPAC EXPY, AUSTIN, TX 78758-2401
(512) 901-4937
(512) 901-3945
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
L0586
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
L0586
TX
208000000X
Pediatrics Physician
Primary
L0586
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030217602
—
TX
Enumeration date
04/17/2006
Last updated
11/18/2022
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