Provider Demographics
NPI:1225305147
Name:GANPATH, SHOPANA (MD)
Entity Type:Individual
Prefix:
First Name:SHOPANA
Middle Name:
Last Name:GANPATH
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 1:1948 E HEBRON PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1515
Mailing Address - Country:US
Mailing Address - Phone:972-939-4646
Mailing Address - Fax:972-939-6161
Practice Address - Street 1:1604 LANCASTER DR
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3544
Practice Address - Country:US
Practice Address - Phone:817-481-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6628207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine