Provider Demographics
NPI:1124400494
Name:SHANGHVI, DHVANI (MD)
Entity Type:Individual
Prefix:
First Name:DHVANI
Middle Name:
Last Name:SHANGHVI
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 1:4900 MUELLER BLVD STE 3S.021
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3051
Mailing Address - Country:US
Mailing Address - Phone:512-324-0095
Mailing Address - Fax:512-324-0183
Practice Address - Street 1:4900 MUELLER BLVD STE 3S.021
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3051
Practice Address - Country:US
Practice Address - Phone:512-324-0095
Practice Address - Fax:512-324-0183
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015019340208000000X
TXR8272208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics