Provider Demographics
NPI:1205389400
Name:JAIN, SHIKHA
Entity type:Individual
Prefix:
First Name:SHIKHA
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12370 ALAMEDA TRACE CIR
Mailing Address - Street 2:APT# 1437
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-6448
Mailing Address - Country:US
Mailing Address - Phone:512-983-8972
Mailing Address - Fax:
Practice Address - Street 1:12370 ALAMEDA TRACE CIR
Practice Address - Street 2:APT# 1437
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-6448
Practice Address - Country:US
Practice Address - Phone:512-983-8972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1258756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist