Provider Demographics
NPI:1356419980
Name:BHANDARI, SATHYA (MD)
Entity type:Individual
Prefix:
First Name:SATHYA
Middle Name:
Last Name:BHANDARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 MEDICAL ARTS DR
Mailing Address - Street 2:STE 205
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1747
Mailing Address - Country:US
Mailing Address - Phone:972-355-9038
Mailing Address - Fax:972-355-2038
Practice Address - Street 1:3901 FM 2181 STE 300
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-4250
Practice Address - Country:US
Practice Address - Phone:972-355-9038
Practice Address - Fax:972-355-2038
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08177100174400000X
TXP3289204R00000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No174400000XOther Service ProvidersSpecialist
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ320089493OtherTAX ID#
NJ320089493OtherTAX ID#