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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1275154882

Shasta Theodore, MD is a Student in an Organized Health Care Education/Training Program in San Antonio, Texas. Registered with an NPI since 2020.

In the registry since
2020
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

7703 Floyd Curl Dr # MC7750
San Antonio, TX 78229-3901
Phone: (936) 446-0466
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Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1275154882
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 5, 2020
Last updated in NPPESMay 5, 2020
Certification dateMay 5, 2020
Mailing address7703 Floyd Curl Dr # Mc7750, San Antonio, TX 78229-3901

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