Basic Information
| Provider Information | |||||||||
| NPI: | 1508865866 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | ALPESH | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2950 CULLEN BLVD | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775843921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134419909 | ||||||||
| FaxNumber: | 2814857305 | ||||||||
| Practice Location | |||||||||
| Address1: | 2950 CULLEN BLVD | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775843921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134419909 | ||||||||
| FaxNumber: | 2814857305 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2005 | ||||||||
| LastUpdateDate: | 03/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | K8835 | TX | N | Other Service Providers | Specialist | 207RI0011X | K8835 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 046623701 | 05 | TX | MEDICAID | 0466237-01 | 05 | TX | MEDICAID | 8FH199 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 046623703 | 05 | TX | MEDICAID |