Provider Demographics
NPI:1467545566
Name:GARG, SANDEEP A (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:A
Last Name:GARG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 700686
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-0686
Mailing Address - Country:US
Mailing Address - Phone:214-373-6165
Mailing Address - Fax:214-373-6165
Practice Address - Street 1:17503 OAK MOUNT PL
Practice Address - Street 2:SUITE 444
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7531
Practice Address - Country:US
Practice Address - Phone:214-369-6887
Practice Address - Fax:214-369-6887
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9040207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1274334-01Medicaid
TX1274334-01Medicaid
TX8C9706Medicare ID - Type UnspecifiedINDIVIDUAL #