Provider Demographics
NPI:1003962689
Name:AMAR, SHEILA MADHAVI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:MADHAVI
Last Name:AMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 S AUSTIN AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7554
Mailing Address - Country:US
Mailing Address - Phone:512-868-6673
Mailing Address - Fax:
Practice Address - Street 1:3201 S AUSTIN AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7554
Practice Address - Country:US
Practice Address - Phone:512-868-6673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104888207KA0200X
CO44555207KA0200X
TXN2917207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730377284OtherNPI
TXF77545Medicare UPIN
00151KMedicare PIN