Provider Demographics
NPI:1457726812
Name:SAJI PILLAI M.D., PA
Entity Type:Organization
Organization Name:SAJI PILLAI M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAJI
Authorized Official - Middle Name:
Authorized Official - Last Name:PILLAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-546-5412
Mailing Address - Street 1:PO BOX 93837
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-0117
Mailing Address - Country:US
Mailing Address - Phone:469-546-5412
Mailing Address - Fax:469-574-5476
Practice Address - Street 1:2400 RIDGECREST DR
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-2602
Practice Address - Country:US
Practice Address - Phone:469-546-5412
Practice Address - Fax:469-574-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2753207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI49673Medicare UPIN