Provider Demographics
NPI:1518906593
Name:KHALSA, SAT KARTAR SINGH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAT KARTAR
Middle Name:SINGH
Last Name:KHALSA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 HOOD ST
Mailing Address - Street 2:STE 101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4926
Mailing Address - Country:US
Mailing Address - Phone:469-271-9259
Mailing Address - Fax:214-771-0593
Practice Address - Street 1:3011 HOOD ST
Practice Address - Street 2:STE 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4926
Practice Address - Country:US
Practice Address - Phone:469-271-9259
Practice Address - Fax:214-771-0593
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31114103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1178352-09Medicaid
TX1178352-09Medicaid