Provider Demographics
NPI:1669772554
Name:SANDIP DESAI MD PA
Entity type:Organization
Organization Name:SANDIP DESAI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-213-5051
Mailing Address - Street 1:16959 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3481
Mailing Address - Country:US
Mailing Address - Phone:832-255-6632
Mailing Address - Fax:832-255-6633
Practice Address - Street 1:16959 SOUTHWEST FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3481
Practice Address - Country:US
Practice Address - Phone:832-255-6632
Practice Address - Fax:832-255-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1073207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty