Individual
AMITABH SHUKLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1601 MAIN ST, SUITE#201, RICHMOND, TX 77469-3247
(281) 341-1500
(281) 341-1505
Mailing address
1601 MAIN ST, SUITE#201, RICHMOND, TX 77469-3247
(281) 341-1500
(281) 341-1505
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
H5969
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0027ET
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/21/2006
Last updated
07/08/2007
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