Provider Demographics
NPI:1588820112
Name:ALICK-LINDSTROM, SASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:
Last Name:ALICK-LINDSTROM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD # E1.202B
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-6250
Mailing Address - Country:US
Mailing Address - Phone:214-648-9494
Mailing Address - Fax:210-344-2649
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-645-8800
Practice Address - Fax:214-645-8801
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27029-R207R00000X
TXP24132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX297138401Medicaid