Provider Demographics
NPI:1619372224
Name:UPADHYAYA, SANJAY (MS, L/CPO, FAAOP)
Entity Type:Individual
Prefix:
First Name:SANJAY
Middle Name:
Last Name:UPADHYAYA
Suffix:
Gender:M
Credentials:MS, L/CPO, FAAOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9888 BISSONNET ST STE 530
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8250
Mailing Address - Country:US
Mailing Address - Phone:832-775-0633
Mailing Address - Fax:281-207-5339
Practice Address - Street 1:9888 BISSONNET ST STE 530
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8250
Practice Address - Country:US
Practice Address - Phone:832-775-0633
Practice Address - Fax:281-207-5339
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPO1505222Z00000X, 224P00000X
224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist