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NPI Code Detail

MEDICARE: ISHETA SHAHED M.D.

MEDICARE: ISHETA SHAHED M.D.
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
12084P0804XChild & Adolescent Psychiatry PhysicianN8146TX

General Provider Information

NPI Number : 1548592603
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISHETA SHAHED M.D.
Provider Business Mailing Address
First Line : 1345 RIVER BEND DR
Second Line :
City : DALLAS
State : TX
Zip : 75247-6943
Country : US
Telephone Number : 214-743-6159
Fax Number :
Provider Business Practice Location Address
First Line : 1020 S CARRIER PKWY
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75051-1527
Country : US
Telephone Number : 214-743-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2010
Last Update Date : 12/08/2025

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