Provider Demographics
NPI:1144485640
Name:SHAH, SYED K (MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:K
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 MIDLANE DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3229
Mailing Address - Country:US
Mailing Address - Phone:956-230-6320
Mailing Address - Fax:956-230-6321
Practice Address - Street 1:1502 MIDLANE DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3229
Practice Address - Country:US
Practice Address - Phone:956-230-6320
Practice Address - Fax:956-230-6321
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8815208000000X, 2080N0001X
IN01069329A2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX335870702OtherCSHCN
TX094872102Medicaid