Provider Demographics
NPI:1861707150
Name:KASHYAP, POOJA KHURANA (MD)
Entity type:Individual
Prefix:DR
First Name:POOJA
Middle Name:KHURANA
Last Name:KASHYAP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:903 W MARTIN ST # MS 49-2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-0903
Mailing Address - Country:US
Mailing Address - Phone:201-358-5909
Mailing Address - Fax:210-358-5940
Practice Address - Street 1:21727 IH 10 W STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-2108
Practice Address - Country:US
Practice Address - Phone:210-644-1230
Practice Address - Fax:210-702-4615
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN15533208000000X
TXQ23152080P0202X, 208000000X
FLME 1133772080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics