Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | Q4801 | TX |
N | 207KA0200X | Allergist | Q4801 | TX |
NPI | 1639380371 |
---|---|
Provider Name | Shikha Mane |
First Address | Denton, TX 76201-2398 |
Second Address | Denton, TX 76201-2398 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07920 | (05) | LA |
47-4361713 | TAX ID (01) | TX |