Provider Demographics
NPI:1811101512
Name:SHAH, RISHIN D (MD)
Entity type:Individual
Prefix:
First Name:RISHIN
Middle Name:D
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 1:5760 LEGACY DR
Mailing Address - Street 2:STE B3-424
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7102
Mailing Address - Country:US
Mailing Address - Phone:972-391-1940
Mailing Address - Fax:972-391-2061
Practice Address - Street 1:6201 DALLAS PKWY STE 210
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4181
Practice Address - Country:US
Practice Address - Phone:972-947-2447
Practice Address - Fax:469-661-2330
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4693207RI0011X
NY262983207R00000X
IL036.124200207R00000X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX349774503Medicaid
TX349774501Medicaid
TX349774502Medicaid
TX438592YSN3Medicare PIN
TX438592YU6XMedicare PIN
TX438592YSHRMedicare PIN