Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | T1406 | TX |
Y | 111NI0900X | Internist | T1406 | TX |
N | 207RG0100X | Gastroenterologist | T1406 | TX |
NPI | 1023506375 |
---|---|
Provider Name | Shivani Kastuar |
First Address | Philadelphia, PA 19104-4238 |
Second Address | Houston, TX 77030-1608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2018 |
Last Update Date | 05/01/2022 |