Individual
DR. AVANTHI TAYI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-1811
(214) 456-2382
(214) 456-6133
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 456-2382
(214) 456-6133
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A124972
CA
208000000X
Pediatrics Physician
P3978
TX
2080P0207X
Pediatric Hematology & Oncology Physician
A124972
CA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
P3978
TX
Other
Enumeration date
03/30/2009
Last updated
12/14/2020
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