Provider Demographics
NPI:1376933176
Name:SHELARE, SULBHA
Entity Type:Individual
Prefix:
First Name:SULBHA
Middle Name:
Last Name:SHELARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7629 TIKI DR
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1548
Mailing Address - Country:US
Mailing Address - Phone:281-346-0018
Mailing Address - Fax:281-346-0913
Practice Address - Street 1:7629 TIKI DR
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1548
Practice Address - Country:US
Practice Address - Phone:281-346-0018
Practice Address - Fax:281-346-0913
Is Sole Proprietor?:No
Enumeration Date:2015-01-31
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09595363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant