Provider Demographics
NPI:1154646958
Name:SINGH MEDICAL PRACTICE, PLLC
Entity Type:Organization
Organization Name:SINGH MEDICAL PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KULDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-491-1723
Mailing Address - Street 1:4564 JENKINS DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4721
Mailing Address - Country:US
Mailing Address - Phone:972-832-7178
Mailing Address - Fax:
Practice Address - Street 1:3900 W 15TH ST
Practice Address - Street 2:SUITE 503
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7751
Practice Address - Country:US
Practice Address - Phone:972-596-5522
Practice Address - Fax:972-596-8976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0465207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH31562Medicare PIN