MEDICARE: DR. POOJA KHURANA KASHYAP MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0002X	Adult Congenital Heart Disease Physician	Q2315	TX
2	208000000X	Pediatrics Physician	TRN15533	FL
3	208000000X	Pediatrics Physician	Q2315	TX
4	2080P0202X	Pediatric Cardiology Physician	ME 113377	FL
5	2080P0202X	Pediatric Cardiology Physician	Q2315	TX

General Provider Information

NPI Number	:	1861707150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. POOJA KHURANA KASHYAP MD

Provider Business Mailing Address
First Line	:	903 W MARTIN ST # MS 49-2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-0903
Country	:	US
Telephone Number	:	201-358-5909
Fax Number	:	210-358-5940

Provider Business Practice Location Address
First Line	:	21727 IH 10 W STE 103
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-2108
Country	:	US
Telephone Number	:	210-644-1230
Fax Number	:	210-702-4615

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	07/24/2025

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