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General NPI Number Information
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NPI Number | 1306012166
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Entity Type | Individual
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Provider Name | SHAILY PATEL KESANI MD
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Gender | Female
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 4471 LONG PRAIRIE RD SUITE 100
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1795
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Country | US
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Telephone | 972-316-4555
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Fax | 972-316-4550
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Provider Business Mailing Address
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Address Line | 4471 LONG PRAIRIE RD SUITE 100
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1795
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Country | US
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Telephone | 972-316-4555
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Fax | 972-316-4550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036.127261
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | Q3213
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License Number State | TX
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