Provider Demographics
NPI:1609538743
Name:KUNDU, SHORO (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHORO
Middle Name:
Last Name:KUNDU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1881
Mailing Address - Country:US
Mailing Address - Phone:972-369-4220
Mailing Address - Fax:214-540-9470
Practice Address - Street 1:4801 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1881
Practice Address - Country:US
Practice Address - Phone:972-369-4220
Practice Address - Fax:214-540-9470
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX738174363LF0000X
TXAP145244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily