Provider Demographics
NPI:1487182473
Name:SIPOS, TIMOTHY PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:PETER
Last Name:SIPOS
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 1:21502 MERCHANTS WAY STE A
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2515
Mailing Address - Country:US
Mailing Address - Phone:281-944-2232
Mailing Address - Fax:205-558-2554
Practice Address - Street 1:902 FROSTWOOD DR STE 256
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2418
Practice Address - Country:US
Practice Address - Phone:346-585-2020
Practice Address - Fax:281-800-8321
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU2642207W00000X
ALMD.42375207WX0107X, 207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1487182473Medicaid