Individual
ASHITH SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 724-5437
(254) 724-7603
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(716) 366-0885
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Q1743
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
Q1743
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02676319
—
NY
Enumeration date
08/28/2006
Last updated
10/16/2020
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