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General NPI Number Information
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NPI Number | 1548296429
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Entity Type | Individual
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Provider Name | K J SHANKAR MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 3301 MATLOCK RD
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City | ARLINGTON
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State | TX
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Zip | 76015-2908
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Country | US
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Telephone | 682-509-5012
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Fax | 682-509-6511
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Provider Business Mailing Address
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Address Line | 13737 NOEL RD STE 1500
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City | DALLAS
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State | TX
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Zip | 75240-1331
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Country | US
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Telephone | 214-217-1951
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Fax | 866-858-0622
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 249826
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 43941
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M3385
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 43941
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 249826
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License Number State | MA
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