Provider Demographics
NPI:1003348004
Name:KESH, SUSAMITA (MD)
Entity Type:Individual
Prefix:
First Name:SUSAMITA
Middle Name:
Last Name:KESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3051 CHURCHILL DR STE 130
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2710
Mailing Address - Country:US
Mailing Address - Phone:972-539-0086
Mailing Address - Fax:972-355-9680
Practice Address - Street 1:3051 CHURCHILL DR STE 130
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2710
Practice Address - Country:US
Practice Address - Phone:972-539-0086
Practice Address - Fax:972-355-9680
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT5593207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology