Provider Demographics
NPI:1982661674
Name:SHRIKHANDE, SHUBHADA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SHUBHADA
Middle Name:S
Last Name:SHRIKHANDE
Suffix:
Gender:F
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:12221 RENFERT WAY STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5453
Practice Address - Country:US
Practice Address - Phone:512-873-8900
Practice Address - Fax:512-834-8676
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6634207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159463203Medicaid
TXP01415823OtherRAILROAD MEDICARE
TX159463201Medicaid
TX159463202Medicaid
TX364339YK4EMedicare PIN
TXH51114Medicare UPIN
TX159463201Medicaid
TX159463203Medicaid
TXP00040708Medicare PIN
TX8A6329Medicare PIN