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:
Health care specialties
| Specialty | Code | License # | 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 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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