Provider Demographics
NPI:1477534964
Name:SINGH, SURINDER J (MD)
Entity Type:Individual
Prefix:
First Name:SURINDER
Middle Name:J
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2898
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604-2898
Mailing Address - Country:US
Mailing Address - Phone:325-677-2201
Mailing Address - Fax:325-677-7641
Practice Address - Street 1:401 CYPRESS ST
Practice Address - Street 2:# 110
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5122
Practice Address - Country:US
Practice Address - Phone:325-677-2201
Practice Address - Fax:325-677-7641
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG20802085R0203X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134638905Medicaid
TX82R518Medicare PIN
TX134638905Medicaid
TXC2080Medicare UPIN