Organization
JAGDISH A. SHAH,MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAGDISH AMRATLAL SHAH M.D. (OWNER)
(903) 583-7424
Entity
Organization
Contact information
Practice address
1220 EAST 6TH STREET, BONHAM, TX 75418
(903) 583-7424
(903) 583-0442
Mailing address
1220 E 6TH ST, BONHAM, TX 75418-4017
(903) 583-7424
(903) 583-0442
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J2792
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080892501
—
TX
Enumeration date
05/03/2007
Last updated
07/08/2010
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