Provider Demographics
NPI:1033114459
Name:CHOWDHARY, SULTAN ALEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:SULTAN
Middle Name:ALEEM
Last Name:CHOWDHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4201 MEDICAL CENTER DR
Mailing Address - Street 2:STE 180
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1766
Mailing Address - Country:US
Mailing Address - Phone:469-714-0515
Mailing Address - Fax:214-548-5093
Practice Address - Street 1:2698 N GALLOWAY AVE
Practice Address - Street 2:STE 103
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6383
Practice Address - Country:US
Practice Address - Phone:972-686-6646
Practice Address - Fax:214-548-5093
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8960207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047156701Medicaid
TX083503501Medicaid
TX830002198OtherRAILROAD MEDICARE
TX0385910001Medicare NSC
TX88X670Medicare PIN
G08204Medicare UPIN
TX047156701Medicaid
TX0385910002Medicare NSC
TX8373B7Medicare PIN