Active NPI
Tejal Shah
- Pharmacist
- Allen, TX
National Provider Identifier
1396275939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS55691
- Practice address
- 408 N Allen Dr Ste 100
Allen, TX 75013-2500 - Phone
- (469) 257-4200
- NPI assigned
- Jun 15, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 64176 | TX | |
| Pharmacist | 183500000X | PS55691 | FL | Primary |
Addresses
Primary practice location
408 N Allen Dr Ste 100
Allen, TX 75013-2500
Mailing address
19152 Dove Creek Dr
Tampa, FL 33647-3073
Phone (813) 507-7211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS55691 | FL | MD | Pharmacist |
| 64176 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridge Manor Pharmacy | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1396275939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19152 DOVE CREEK DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336473073",
"telephone_number": "813-507-7211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 N ALLEN DR STE 100",
"city": "ALLEN",
"state": "TX",
"postal_code": "750132500",
"telephone_number": "469-257-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "TEJAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-15",
"last_updated": "2021-10-29",
"certification_date": "2021-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "64176",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS55691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.