Provider Demographics
NPI:1942504238
Name:SIDHU, MANJOT K (OD)
Entity Type:Individual
Prefix:DR
First Name:MANJOT
Middle Name:K
Last Name:SIDHU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8880 STATE HIGHWAY 121
Mailing Address - Street 2:STE 140
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3132
Mailing Address - Country:US
Mailing Address - Phone:469-854-6787
Mailing Address - Fax:
Practice Address - Street 1:8532 DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8300
Practice Address - Country:US
Practice Address - Phone:817-503-0618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-01
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7675T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist