Individual
ISHWARA R SANKARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 890, FORT WORTH, TX 76104-2145
(817) 250-4280
(817) 250-4281
Mailing address
1325 PENNSYLVANIA AVE STE 890, FORT WORTH, TX 76104-2145
(817) 250-4280
(817) 250-4281
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29805
SC
2084A2900X
Neurocritical Care Physician
Primary
P3577
TX
2084N0400X
Neurology Physician
P3577
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298056
—
SC
01
—
CJ2703
RR MEDICARE
SC
Enumeration date
05/17/2007
Last updated
03/23/2020
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