Provider Demographics
NPI:1336474501
Name:BASRA, SUKHDEEP SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUKHDEEP
Middle Name:SINGH
Last Name:BASRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 RICHTON ST
Mailing Address - Street 2:APT 22-1A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3228
Mailing Address - Country:US
Mailing Address - Phone:832-472-7262
Mailing Address - Fax:
Practice Address - Street 1:7900 CAMBRIDGE ST
Practice Address - Street 2:APT 22-1A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5502
Practice Address - Country:US
Practice Address - Phone:832-472-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10034453207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine