Shasta Theodore, MD is a student in an organized health care education training program in San Antonio, TX. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Shasta Theodore, MD NPI is 1275154882. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
7703 FLOYD CURL DR # MC7750
SAN ANTONIO, TX
ZIP 78229-901
Phone: (936) 446-0466
The enumeration date for this NPI number is 5/5/2020 and was last updated on 5/5/2020.