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Individual
SHUBA SRINIVASAN
Active
Individual
SHUBA SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03337
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192819401
—
TX
05
—
192819402
—
TX
05
—
192819403
—
TX
Enumeration date
05/27/2006
Last updated
04/11/2017
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