Individual
SHIVARAMAIAH SHASHIKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 MEDICAL PLAZA DR, SUITE 250, THE WOODLANDS, TX 77380-3476
(281) 296-8788
(281) 419-1291
Mailing address
1111 MEDICAL PLAZA DR, SUITE 250, THE WOODLANDS, TX 77380-3476
(281) 296-8788
(281) 419-1291
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036135951
IL
207R00000X
Internal Medicine Physician
2003015692
MO
207R00000X
Internal Medicine Physician
P7565
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036135951
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
P7565
TX
208M00000X
Hospitalist Physician
2003015692
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209115500
—
MO
05
—
327502603
—
TX
01
—
8EF484
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/13/2006
Last updated
08/21/2016
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