Jaydeep S. Shah, M.D. PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

L0930 Issued in TX

Legal business name

JAYDEEP S. SHAH, M.D. PLLC

Practice address

602 Bentley MNR
Shavano Park, TX 78249-2079

Phone

(210) 387-7693

Fax

(210) 481-3793

NPI assigned

Apr 17, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jaydeep Shah, M.D.

Title

Managing Partner

Phone

(210) 387-7693

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Children's Anesthesia of San Antonio Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1205360203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 BENTLEY MNR",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492079",
            "telephone_number": "210-387-7693",
            "fax_number": "210-481-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 BENTLEY MNR",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492079",
            "telephone_number": "210-387-7693",
            "fax_number": "210-481-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYDEEP S. SHAH, M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JAYDEEP",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "210-387-7693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "L0930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046693002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Anesthesia of San Antonio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teresa E Hirst, CPNP
• Bianca Horton, MS SLP -INTERN
• Priscilla Hover, PA-C
• Kathleen Howard, CNIM
• Michelle Lynae Iverson, M.D.
• JM Dental Services, PLLC
• Kaiser Family Medical Management
• David R Kaiser, D.C.
• Lindsay Jo Kane
• Daniel Katselnik, MD

• Anesthesiology Physician in Shavano Park, TX
• Providers in Shavano Park, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.