Individual
MISS LEAH ANNE SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1201 BROADMOOR DR APT 215, AUSTIN, TX 78723-3113
(512) 992-5354
Mailing address
1201 BROADMOOR RD #215, AUSTIN, TX 78723
(512) 992-5354
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
112719
TX
Other
Enumeration date
05/10/2011
Last updated
05/10/2011
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