Individual
DR. SHAILENDRA DAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-6299
(682) 885-1090
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
M8617
TX
2080P0214X
Pediatric Pulmonology Physician
Primary
M8617
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282070602
—
TX
05
—
282070604
—
TX
Enumeration date
05/12/2010
Last updated
11/05/2012
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