Provider Demographics
NPI:1841839271
Name:SHENDE, ANAMIKA MADHUKAR (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:ANAMIKA
Middle Name:MADHUKAR
Last Name:SHENDE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 CAMDEN CV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7290
Mailing Address - Country:US
Mailing Address - Phone:979-571-0354
Mailing Address - Fax:
Practice Address - Street 1:5410 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3554
Practice Address - Country:US
Practice Address - Phone:210-541-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1255068225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist