Provider Demographics
NPI:1952301418
Name:SACHDEV, LISA (DO, PA,)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SACHDEV
Suffix:
Gender:F
Credentials:DO, PA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:671 CUMBERLAND RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4886
Mailing Address - Country:US
Mailing Address - Phone:346-810-0836
Mailing Address - Fax:281-542-7731
Practice Address - Street 1:119 W PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5420
Practice Address - Country:US
Practice Address - Phone:281-542-7800
Practice Address - Fax:281-542-7731
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK5624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159641301Medicaid
TX0008JUOtherBCBS