Provider Demographics
NPI:1548424211
Name:DACHA, SUNIL
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:
Last Name:DACHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 1201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2740
Mailing Address - Country:US
Mailing Address - Phone:713-441-3372
Mailing Address - Fax:404-727-5596
Practice Address - Street 1:6550 FANNIN ST STE 1201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-441-3372
Practice Address - Fax:404-727-5596
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.054237207R00000X
WI56006207R00000X
GA074089207RG0100X
TXR7427207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX391474901Medicaid