Individual
DR. KAVITHA SHASHIKUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6528 SAUCON VALLEY DR, FORT WORTH, TX 76132-5452
(817) 819-4919
Mailing address
PO BOX 16387, FORT WORTH, TX 76162-0387
(817) 294-1408
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
100265
GA
207RI0200X
Infectious Disease Physician
L5558
TX
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
100265
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154604602
—
TX
Enumeration date
09/06/2006
Last updated
03/28/2025
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