Provider Demographics
NPI:1265635510
Name:SHANKAR, SANGEETHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANGEETHA
Middle Name:
Last Name:SHANKAR
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 1:7400 FANNIN ST STE 810
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1935
Mailing Address - Country:US
Mailing Address - Phone:713-512-8500
Mailing Address - Fax:
Practice Address - Street 1:22999 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4412
Practice Address - Country:US
Practice Address - Phone:281-348-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99314208000000X
TXN8852208M00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280273805Medicaid
FL278899300Medicaid
TX280273802Medicaid
TX280273806Medicaid
TX280273804Medicaid