Provider Demographics
NPI:1114928538
Name:SHARDA, GIREESH (MD)
Entity Type:Individual
Prefix:
First Name:GIREESH
Middle Name:
Last Name:SHARDA
Suffix:
Gender:M
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:PO BOX 192347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-8518
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10830 N CENTRAL EXPY
Practice Address - Street 2:STE 225
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2140
Practice Address - Country:US
Practice Address - Phone:214-382-5051
Practice Address - Fax:214-382-5054
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0932208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH74058Medicare UPIN
TXDF8616Medicare PIN
TX8D9212Medicare PIN
TX00868WMedicare PIN