Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Krishna Pancham, MD

Individual provider Pediatric Pulmonology Physician · NPI 1619107042

Krishna Pancham, MD is a Pediatric Medicine in Fort Worth, Texas. Qualified in 2005, 21 years ago. Practices with Cook Childrens Physician Network, a 301-clinician group and accepts Medicare assignment. Licensed in Kentucky and Texas.

Years since qualifying
21
Licensed in
KY, TX
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1500 Cooper St
Fort Worth, TX 76104-2710
Phone: (682) 885-6299
Fax: (682) 885-1090
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Pulmonology Physician (primary) Taxonomy 2080P0214X · Licence T0306 (TX)
Pediatric Pulmonology Physician Taxonomy 2080P0214X · Licence 47974 (KY)

Record details

NPI number1619107042
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 20, 2009
Last updated in NPPESJuly 15, 2021
Certification dateJuly 15, 2021
Mailing addressPo Box 733784, Dallas, TX 75373-3784

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Cook Childrens Physician Network — 301 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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