Provider Demographics
NPI:1760594329
Name:SHRESTHA, SHREE OM (MD)
Entity Type:Individual
Prefix:
First Name:SHREE
Middle Name:OM
Last Name:SHRESTHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3500 SOUTH IH 35
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-9426
Mailing Address - Country:US
Mailing Address - Phone:254-939-2100
Mailing Address - Fax:254-939-2334
Practice Address - Street 1:3500 SOUTH IH 35
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-9426
Practice Address - Country:US
Practice Address - Phone:254-939-2100
Practice Address - Fax:254-939-2334
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT20050166472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry