Provider Demographics
NPI:1225367659
Name:SHALINI KATIKANENI MD PA
Entity type:Organization
Organization Name:SHALINI KATIKANENI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:KATIKANENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-816-2937
Mailing Address - Street 1:7509 NEW HEART DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3973
Mailing Address - Country:US
Mailing Address - Phone:972-816-2937
Mailing Address - Fax:
Practice Address - Street 1:7509 NEW HEART DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3973
Practice Address - Country:US
Practice Address - Phone:972-816-2937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0878174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty