Organization
AITAZAZ A. SHAH M.D PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AITAZAZ A SHAH M.D (PRESIDENT)
(940) 380-8100
Entity
Organization
Contact information
Practice address
2900 N I-35, SUITE 118, DENTON, TX 76201-5141
(940) 380-8100
(940) 380-8112
Mailing address
2900 N I-35, SUITE 118, DENTON, TX 76201-5141
(940) 380-8100
(940) 380-8112
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
L9471
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001MS
BSBS OF TEXAS
TX
05
—
1753279
—
TX
01
—
8F0492
MEDICARE
TX
Enumeration date
01/10/2008
Last updated
01/10/2008
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