Provider Demographics
NPI:1558378307
Name:DHARMA, SHASHI K (MD)
Entity Type:Individual
Prefix:
First Name:SHASHI
Middle Name:K
Last Name:DHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1701 W ROYAL LN STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3231
Mailing Address - Country:US
Mailing Address - Phone:972-331-1590
Mailing Address - Fax:972-331-1599
Practice Address - Street 1:1701 W ROYAL LN STE 200
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3231
Practice Address - Country:US
Practice Address - Phone:972-331-1590
Practice Address - Fax:972-331-1599
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0293207WX0009X, 207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121065001Medicaid
TX00H36TMedicare PIN
TX121065001Medicaid