Provider Demographics
NPI:1093414328
Name:SINDHU, AQSA IQBAL
Entity Type:Individual
Prefix:
First Name:AQSA
Middle Name:IQBAL
Last Name:SINDHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IMRAN ALI
Other - Middle Name:
Other - Last Name:MUSTAFA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:14533 LITTLE ANNE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2736
Mailing Address - Country:US
Mailing Address - Phone:406-792-9374
Mailing Address - Fax:
Practice Address - Street 1:14533 LITTLE ANNE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-2736
Practice Address - Country:US
Practice Address - Phone:406-792-9374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20120029OtherAGENT