Provider Demographics
NPI:1740260785
Name:SINGH, SHAILI MATTA (MD)
Entity type:Individual
Prefix:
First Name:SHAILI
Middle Name:MATTA
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAILI
Other - Middle Name:S
Other - Last Name:MATTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15803 WINDERMERE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15803 WINDERMERE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2402
Practice Address - Country:US
Practice Address - Phone:512-231-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1912208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics