Provider Demographics
NPI:1154619369
Name:DESAI, SHUCHI (MD)
Entity type:Individual
Prefix:
First Name:SHUCHI
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3809 W 15TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7790
Mailing Address - Country:US
Mailing Address - Phone:972-379-2416
Mailing Address - Fax:972-867-1018
Practice Address - Street 1:3809 W 15TH ST
Practice Address - Street 2:STE A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7190
Practice Address - Country:US
Practice Address - Phone:972-379-2416
Practice Address - Fax:972-867-1018
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011016909207V00000X
TXQ3664207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology