Healthcare Provider Details

I. General information

NPI: 1568211035
Provider Name (Legal Business Name): KRITI SHRESTHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 08/12/2025
Certification Date:
Deactivation Date: 01/10/2025
Reactivation Date: 08/12/2025

III. Provider practice location address

1400 S. COULTER STREET
AMARILLO TX
79106
US

IV. Provider business mailing address

1400 S. COULTER STREET
AMARILLO TX
79106
US

V. Phone/Fax

Practice location:
  • Phone: 806-414-9654
  • Fax: 806-351-3787
Mailing address:
  • Phone: 806-414-9654
  • Fax: 806-351-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: