Provider Demographics
NPI:1417247321
Name:KAMDAR, SANGEETA C (AUD)
Entity Type:Individual
Prefix:
First Name:SANGEETA
Middle Name:C
Last Name:KAMDAR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BALCONES DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4252
Mailing Address - Country:US
Mailing Address - Phone:512-836-8786
Mailing Address - Fax:512-836-8794
Practice Address - Street 1:5750 BALCONES DR
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4252
Practice Address - Country:US
Practice Address - Phone:512-836-8786
Practice Address - Fax:512-836-8794
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2019-02-01
Deactivation Date:2018-04-30
Deactivation Code:
Reactivation Date:2019-02-01
Provider Licenses
StateLicense IDTaxonomies
TX80319231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80730AOtherBCBS- AENTC
TX80729AOtherBCBS - HCAENTC