Basic Information
Provider Information
NPI: 1326268087
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SETHI
FirstName: SHIKHA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4780 N JOSEY LN
Address2:  
City: CARROLLTON
State: TX
PostalCode: 750104615
CountryCode: US
TelephoneNumber: 9724921334
FaxNumber: 9724925174
Practice Location
Address1: 4780 N JOSEY LN
Address2:  
City: CARROLLTON
State: TX
PostalCode: 750104615
CountryCode: US
TelephoneNumber: 9724921334
FaxNumber: 9724925174
Other Information
ProviderEnumerationDate: 04/26/2007
LastUpdateDate: 02/01/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000XM6874TXY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 
2081S0010XM6874TXN Allopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine

ID Information
IDTypeStateIssuerDescription
TXB11751201TXMEDICARE PART B - EFFECT 02/01/2011OTHER
8CR15601TXBCBS TX 02/01/2011OTHER
P0091335901TXRAILROAD MEDICAREOTHER


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