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VIDUR SHAH DO
NPI 1053114462
Student in an Organized Health Care Education/Training Program in San Antonio, TX

Active since March 31, 2025PECOS Enrolled
4499 MEDICAL DR STE 171, SAN ANTONIO, TX 78229(210) 575-7002 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Vidur Shah Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIDUR SHAH DO (NPI 1053114462) is an individual student in an organized health care education/training program in San Antonio, Texas and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053114462
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameVIDUR SHAHCredential: DO
Location Address4499 MEDICAL DR STE 171San Antonio, TX 78229-3789
Mailing Address4499 Medical Dr Ste 171San Antonio, TX 78229-3789
Phone(210) 575-7002
Sole ProprietorYes
Enumeration DateMarch 31, 2025
NPPES CertifiedMarch 31, 2025
✔ NPI 1053114462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4499 MEDICAL DR STE 171, San Antonio, TX 78229
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vidur Shah Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GONGKAI LIU DO
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (346) 550-6457
SARITA THANEDAR
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (346) 550-6457
DR. LUIS ANGEL CASTELAN MD
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (210) 575-5564
AARON DANIEL DE LA CRUZ
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (346) 550-6457
DR. SAAD MASUD MD
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (210) 575-9585
KEVIN CHO MD
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (346) 550-6457
KASSIDY FIX DO
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (210) 575-5564
DR. NISHAD MYSORE DO
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Bexar County (346) 550-6457

Frequently Asked Questions

What is Vidur Shah's NPI number?

The NPI number assigned to this healthcare provider is 1053114462, enumerated as an "individual" on March 31, 2025.

Where is the provider located?

The provider is located at 4499 MEDICAL DR STE 171 SAN ANTONIO, TX 78229 and the phone number is (210) 575-7002.

What is the provider's specialty?

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.