Provider Demographics
NPI:1871505271
Name:SHAH, PRATAP C (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:PRATAP
Middle Name:C
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4719 LLANO LOOP
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7084
Mailing Address - Country:US
Mailing Address - Phone:254-421-4213
Mailing Address - Fax:832-905-5941
Practice Address - Street 1:4719 LLANO LOOP
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7084
Practice Address - Country:US
Practice Address - Phone:254-421-4213
Practice Address - Fax:832-905-5941
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168768208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology