DR. KATHLEEN LOUISE SHIDE (NPI# 1073550455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073550455 |
| Entity Type | Individual |
| Full Name | DR. KATHLEEN LOUISE SHIDE |
| Credential | MD |
| Practice Address |
1450 8th Ave Fort Worth TX 76104-4110 |
| Mailing Address |
Po Box 911230 Dallas TX 75391-1230 |
| Practice Telephone | 8179234423 |
| Practice Fax Number | 8179233176 |
| Mailing Telephone | 9729978000 |
| Mailing Fax Number | 9724379605 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2008-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
K3007 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS OF TEXAS | 8S3355 | 01 |
| TX | 166057303 | 05 | |
| TX | 166057302 | 05 |
| Street Address |
1450 8TH AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831192863 | Moncrief Cancer Center | Clinic/Center | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2005-05-23 |
| 1225401029 | Antonia Reese Pryor | Nurse Practitioner | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2015-11-03 |
| 1871856914 | Mani Akhtari | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2012-06-22 |
| 1295932242 | Clinton Sangkyu Park | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2007-07-02 |
| 1033151287 | Rafael Comacho Chan | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2006-06-12 |
| 1528008646 | Gary S Young | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710597869 | Matthew Cavey Md Pa | Radiology | 2900 Acme Brick Plz, Fort Worth, TX 76109-4123 | 2020-08-04 |
| 1700220183 | Nabila Lehachi Waheed | Radiology | 800 W Magnolia Ave, Fort Worth, TX 76104 | 2013-04-29 |
| 1871856914 | Mani Akhtari | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2012-06-22 |
| 1609020031 | Pro Physicians Clinic Pa | Radiology | 800 W Magnolia Ave, Fort Worth, TX 76104-4611 | 2008-11-12 |
| 1225289739 | Pro Physician Clinic Pa | Radiology | 800 W Magnolia Ave, Fort Worth, TX 76104-4611 | 2008-10-02 |
| 1295932242 | Clinton Sangkyu Park | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2007-07-02 |
| 1770515900 | Harold Paul Freeman Jr. | Radiology | 6500 Harris Pkwy, Fort Worth, TX 76132-4136 | 2006-07-07 |
| 1033151287 | Rafael Comacho Chan | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2006-06-12 |
| 1528008646 | Gary S Young | Radiology | 1450 8th Ave, Fort Worth, TX 76104-4110 | 2006-06-07 |
| 1831137454 | Karen Lanette Nielson | Radiology | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2006-06-04 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on DR. KATHLEEN LOUISE SHIDE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.