Provider Demographics
NPI:1467765701
Name:SHETTY, SUCHITH KAVRADY (MD)
Entity type:Individual
Prefix:DR
First Name:SUCHITH
Middle Name:KAVRADY
Last Name:SHETTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4112 W 15TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5874
Mailing Address - Country:US
Mailing Address - Phone:972-612-0388
Mailing Address - Fax:972-612-0389
Practice Address - Street 1:4112 W 15TH ST STE 203
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5874
Practice Address - Country:US
Practice Address - Phone:972-612-0388
Practice Address - Fax:972-612-0389
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCSP.0048399207R00000X
IAMD-44530208M00000X
TXV8766207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist