MEDICARE: SHANKAR VENKAT BDS

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	122300000X	Dentist	42281	TX
2	1223P0106X	Oral and Maxillofacial Pathology Dentistry	14438	NC

General Provider Information

NPI Number	:	1245716661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANKAR VENKAT BDS

Provider Business Mailing Address
First Line	:	507 W COMMERCE ST
Second Line	:
City	:	BROWNWOOD
State	:	TX
Zip	:	76801-1705
Country	:	US
Telephone Number	:	325-510-3023
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 W COMMERCE ST
Second Line	:
City	:	BROWNWOOD
State	:	TX
Zip	:	76801-1705
Country	:	US
Telephone Number	:	325-510-3023
Fax Number	:

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

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	05/04/2026

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Directions to “ SHANKAR VENKAT BDS” Practice Location

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