Provider Demographics
NPI:1184106510
Name:RESHAPED PLLC
Entity type:Organization
Organization Name:RESHAPED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARLENE
Authorized Official - Middle Name:KARMINI
Authorized Official - Last Name:SELVARATNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-431-0544
Mailing Address - Street 1:2008 E HEBRON PKWY STE 114
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1601
Mailing Address - Country:US
Mailing Address - Phone:469-431-0544
Mailing Address - Fax:
Practice Address - Street 1:2008 E HEBRON PKWY #114
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007
Practice Address - Country:US
Practice Address - Phone:469-431-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-01
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7467207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Single Specialty