Provider Demographics
NPI:1336568708
Name:SANDHU, SANJEET S (DO)
Entity Type:Individual
Prefix:
First Name:SANJEET
Middle Name:S
Last Name:SANDHU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 JOE BATTLE BLVD STE E-G
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2609
Mailing Address - Country:US
Mailing Address - Phone:915-264-2944
Mailing Address - Fax:915-800-8570
Practice Address - Street 1:2270 JOE BATTLE BLVD STE E-G
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2609
Practice Address - Country:US
Practice Address - Phone:915-642-9444
Practice Address - Fax:915-800-8570
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR24682080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR2468OtherMEDICAL BOARD