Organization
I. H. SHAH, M.D. AND S. HASAN, M.D. AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IQTIDAR U H SHAH MD (GROUP PRACTITIONER GENERAL SURGEON)
(903) 408-7130
Entity
Organization
Contact information
Practice address
4004 MEDICAL PARKWAY, GREENVILLE, TX 75401
(903) 455-4414
(903) 455-1944
Mailing address
4004 MEDICAL PARKWAY, GREENVILLE, TX 75401
(903) 455-4414
(903) 455-1944
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E0365
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081898101
—
TX
Enumeration date
01/02/2007
Last updated
05/20/2008
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