Provider Demographics
NPI:1659501054
Name:PANKAJ, SHILPA THAKKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:THAKKAR
Last Name:PANKAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1740 W 27TH ST
Mailing Address - Street 2:SUITE #305
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1440
Mailing Address - Country:US
Mailing Address - Phone:713-861-4800
Mailing Address - Fax:713-861-7762
Practice Address - Street 1:1740 W 27TH ST
Practice Address - Street 2:SUITE #305
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1440
Practice Address - Country:US
Practice Address - Phone:713-861-4800
Practice Address - Fax:713-861-7762
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2711208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics