Provider Demographics
NPI:1558652149
Name:MHAPSEKAR, SHAILEN (MD)
Entity type:Individual
Prefix:
First Name:SHAILEN
Middle Name:
Last Name:MHAPSEKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 N LEE TREVINO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4563
Mailing Address - Country:US
Mailing Address - Phone:915-905-9424
Mailing Address - Fax:915-590-9044
Practice Address - Street 1:1721 N LEE TREVINO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4563
Practice Address - Country:US
Practice Address - Phone:915-905-9424
Practice Address - Fax:915-590-9044
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4434207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM80829597Medicaid