Provider Demographics
NPI:1457555799
Name:SANDHU, SIMARDEEP KAUR (MD)
Entity Type:Individual
Prefix:
First Name:SIMARDEEP
Middle Name:KAUR
Last Name:SANDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SIMARDEEP
Other - Middle Name:KAUR
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7808 CLODUS FIELDS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2206
Mailing Address - Country:US
Mailing Address - Phone:972-770-1032
Mailing Address - Fax:469-484-2126
Practice Address - Street 1:7808 CLODUS FIELDS DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2206
Practice Address - Country:US
Practice Address - Phone:972-770-1032
Practice Address - Fax:469-484-2126
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM81592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0022493OtherINSTITUTIONAL PERMIT
TX204700301Medicaid
TX8L15589Medicare PIN