Provider Demographics
NPI:1851395495
Name:SANKA, SHANKAR C (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANKAR
Middle Name:C
Last Name:SANKA
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 1:303 CAVAYO TRL
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4497
Mailing Address - Country:US
Mailing Address - Phone:210-372-9030
Mailing Address - Fax:210-468-1878
Practice Address - Street 1:12446 WEST AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2530
Practice Address - Country:US
Practice Address - Phone:210-729-2262
Practice Address - Fax:210-729-7290
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200301411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2121248OtherMAMSI
NC2566510OtherBCBS
NC2385633OtherUNITED HEALTHCARE
NCP00138558OtherRR MEDICARE
NC89136C9Medicaid
NC7422547OtherAETNA
NCD1187OtherMEDCOST
NC7422547OtherAETNA
NCP00138558OtherRR MEDICARE