Individual
SANDEEP K SHORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2221 8TH AVE, FORT WORTH, TX 76110-1812
(817) 336-5060
(817) 336-1744
Mailing address
2221 8TH AVE, FORT WORTH, TX 76110-1812
(817) 336-5060
(817) 336-1744
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
L2645
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10012349
AMERIGROUP
—
05
—
160371401
—
TX
01
—
1638188
UNISYS MEDICAID
LA
01
—
7776507
AETNA
—
01
—
8K8418
BCBS OF TEXAS
TX
01
—
P00054539
RAILROAD MEDICARE
—
Enumeration date
06/11/2006
Last updated
03/23/2021
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