Provider Demographics
NPI:1588688626
Name:SHAH, ANILA (DDS)
Entity type:Individual
Prefix:
First Name:ANILA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9829 MADELINE ALYSSA CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-4342
Mailing Address - Country:US
Mailing Address - Phone:713-661-3351
Mailing Address - Fax:713-473-8787
Practice Address - Street 1:320 SOUTHMORE AVE STE 312B
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1135
Practice Address - Country:US
Practice Address - Phone:713-473-7733
Practice Address - Fax:713-473-8787
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice