Provider Demographics
NPI:1902841315
Name:MASSANI, KASHMIRA K (MD)
Entity Type:Individual
Prefix:DR
First Name:KASHMIRA
Middle Name:K
Last Name:MASSANI
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:PO BOX 843204
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-3204
Mailing Address - Country:US
Mailing Address - Phone:855-298-6628
Mailing Address - Fax:903-416-1701
Practice Address - Street 1:301 W EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-3045
Practice Address - Country:US
Practice Address - Phone:956-632-4000
Practice Address - Fax:956-961-4286
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0813207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174095302Medicaid
TXP00406252OtherMEDICARE RAILROAD
TXI131454Medicare UPIN
TXP00406252OtherMEDICARE RAILROAD