Provider Demographics
NPI:1356530737
Name:SHARI KUSHWAHA, M.D., P.A.
Entity type:Organization
Organization Name:SHARI KUSHWAHA, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-741-4144
Mailing Address - Street 1:1670 KELLER PKWY
Mailing Address - Street 2:SUITE 170
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3702
Mailing Address - Country:US
Mailing Address - Phone:817-741-4144
Mailing Address - Fax:817-741-4154
Practice Address - Street 1:1670 KELLER PKWY
Practice Address - Street 2:SUITE 170
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3702
Practice Address - Country:US
Practice Address - Phone:817-741-4144
Practice Address - Fax:817-741-4154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7791208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty