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General NPI Number Information
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NPI Number | 1629392865
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Entity Type | Organization
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Legal Business Name | SHIKARIPUR MANJUNATH, MD, PA
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 5960 W PARKER RD STE 278 PMB 121
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City | PLANO
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State | TX
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Zip | 75093-7792
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Country | US
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Telephone | 469-774-8442
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Fax | 972-747-1663
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Provider Business Mailing Address
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Address Line | 5960 W PARKER RD STE 278 PMB 121
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City | PLANO
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State | TX
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Zip | 75093-7792
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Country | US
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Telephone | 469-774-8442
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Fax | 972-747-1663
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Authorized Official
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Title or Position | OWNER
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Name | SHIKARIPUR D MANJUNATH
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Credential | MD
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Telephone | 469-774-8442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | K4140
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License Number State | TX
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