Provider Demographics
NPI:1386845030
Name:THAKRAR, SHIMONA BHATIA (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:SHIMONA
Middle Name:BHATIA
Last Name:THAKRAR
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:DR
Other - First Name:SHIMONA
Other - Middle Name:RAJKUMAR
Other - Last Name:BHATIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO, MPH
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-2111
Mailing Address - Fax:
Practice Address - Street 1:302 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1032
Practice Address - Country:US
Practice Address - Phone:512-509-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034320208000000X
VA0102202633208000000X
TXQ1311208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics