Individual
MONISHA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-2078
(210) 358-1972
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 358-2078
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M2091
TX
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
M2091
TX
208000000X
Pediatrics Physician
M2091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177319401
—
TX
05
—
177319406
—
TX
05
—
177319412
—
TX
01
—
177319413
CSHCN
TX
01
—
1780764118
TRICARE SOUTH
TX
01
—
8BE062
BCBS OF TEXAS
TX
Enumeration date
10/17/2006
Last updated
09/26/2016
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