MEDICARE: KRISHNA SHRESTHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1205544301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISHNA SHRESTHA

Provider Business Mailing Address
First Line	:	CARL R. DARNALL ARMY MEDICAL CENTER
Second Line	:	36065 SANTA FE AVE
City	:	FT HOOD
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 SUTTON PLACE TRL
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-6043
Country	:	US
Telephone Number	:	210-350-9108
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2022
Last Update Date	:	11/08/2022

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