Provider Demographics
NPI:1043409204
Name:SHAILI, MEENAKSHI (WHCNP)
Entity Type:Individual
Prefix:
First Name:MEENAKSHI
Middle Name:
Last Name:SHAILI
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 N WESTMORELAND RD
Practice Address - Street 2:DEHARO-SALDIVAR HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1656
Practice Address - Country:US
Practice Address - Phone:214-266-0580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX744909363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196033802Medicaid
TX196033806Medicaid
TX196033804Medicaid
TX88326UOtherBLUE CROSS BLUE SHIELD
TX196033807Medicaid
TX196033809Medicaid
TX196033810Medicaid
TX196033805Medicaid
TX196033808Medicaid
TX196033801Medicaid