Healthcare Provider Details
I. General information
NPI: 1588846653
Provider Name (Legal Business Name): SHALENE BADHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/30/2007
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3201 S AUSTIN AVE STE 325
GEORGETOWN TX
78626-7642
US
IV. Provider business mailing address
3201 S AUSTIN AVE STE 325
GEORGETOWN TX
78626-7642
US
V. Phone/Fax
- Phone: 507-751-2717
- Fax: 512-713-0844
- Phone: 512-717-5077
- Fax: 512-713-0844
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | T3585 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: