Provider Demographics
NPI:1679673248
Name:SHENKENBERG, TODD D (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:D
Last Name:SHENKENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 TREASURE HILLS BLVD.
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8912
Mailing Address - Country:US
Mailing Address - Phone:956-364-2131
Mailing Address - Fax:956-364-2141
Practice Address - Street 1:1719 TREASURE HILLS BLVD.
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8912
Practice Address - Country:US
Practice Address - Phone:956-364-2131
Practice Address - Fax:956-364-2141
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0110207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137854912Medicaid
TX8H3570OtherBLUE CROSS BLUE SHIELD
TX962870OtherUNITED HEALTH CARE
TX137854912Medicaid
TX962870OtherUNITED HEALTH CARE
TXB26389Medicare UPIN