Individual
DR. GANESH SHANMUGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1602 ROCK PRAIRIE RD, SUITE 270, COLLEGE STATION, TX 77845-8306
(979) 703-6112
(979) 703-6649
Mailing address
1602 ROCK PRAIRIE RD, SUITE 270, COLLEGE STATION, TX 77845-8306
(979) 703-6112
(979) 703-6649
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
M6388
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3201428
—
TX
Enumeration date
05/24/2007
Last updated
06/30/2014
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