Shide, Kathleen Louise

Shide, Kathleen Louise is an individual health care provider with primary practice located at 500 S Henderson St Ste 200 , Fort Worth TX 76104-2154. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Shide, Kathleen Louise can be contacted via phone (174) 131-5008.

Contact Information

Primary practice address
500 S Henderson St Ste 200 Fort Worth TX 76104-2154
Phone: (174) 131-5008
Fax: (817) 413-1499
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X K3007 Texas

Profile Details

NPI number 1073550455
LBN Legal business name Shide, Kathleen Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Dec 9th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073550455 NPPES
Texas Other 8S3355 BLUE CROSS OF TEXAS
Texas MEDICAID 166057303 BLUE CROSS OF TEXAS
Texas MEDICAID 166057302 BLUE CROSS OF TEXAS

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