Provider Demographics
NPI:1629011135
Name:DESAI, SATISH D (MD)
Entity Type:Individual
Prefix:DR
First Name:SATISH
Middle Name:D
Last Name:DESAI
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2250
Mailing Address - Fax:956-362-2251
Practice Address - Street 1:2717 MICHAELANGELO DR STE 200
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1412
Practice Address - Country:US
Practice Address - Phone:956-362-2250
Practice Address - Fax:956-362-2251
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9658207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156028603Medicaid
TX156028602Medicaid
TX156028604Medicaid
TX8R1425OtherBLUE CROSS OF TEXAS
TX156028605Medicaid
TX8R1425OtherBLUE CROSS OF TEXAS
F99444Medicare UPIN
TX156028602Medicaid
TX8D2068Medicare PIN
TX830008700Medicare PIN
TX156028604Medicaid
TX156028603Medicaid