Provider Demographics
NPI:1972568715
Name:AGGARWAL, SUDHIR K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHIR
Middle Name:K
Last Name:AGGARWAL
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 669162
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-9162
Mailing Address - Country:US
Mailing Address - Phone:800-343-0269
Mailing Address - Fax:504-842-4845
Practice Address - Street 1:2390 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4205
Practice Address - Country:US
Practice Address - Phone:337-261-6000
Practice Address - Fax:337-261-6003
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA305198207RH0003X
GA065332207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2443674Medicaid
LA305198OtherLA STATE LICENSE
AZ642563Medicaid
AZ68464Medicare ID - Type UnspecifiedMEDICARE NUMBER