Provider Demographics
NPI:1851313985
Name:KULKARNI, SHARAD B (MD)
Entity Type:Individual
Prefix:MR
First Name:SHARAD
Middle Name:B
Last Name:KULKARNI
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 1:2825 INTERSTATE 10 E STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1015
Mailing Address - Country:US
Mailing Address - Phone:409-835-7401
Mailing Address - Fax:409-835-7405
Practice Address - Street 1:2825 INTERSTATE 10 E STE 100
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1015
Practice Address - Country:US
Practice Address - Phone:409-835-7401
Practice Address - Fax:409-835-7405
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG42362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128859904Medicaid
TX00U41TMedicare PIN
TXE19440Medicare UPIN