Provider Demographics
NPI:1720100027
Name:MUKERJI, SIDDHARTH S (MD)
Entity Type:Individual
Prefix:
First Name:SIDDHARTH
Middle Name:S
Last Name:MUKERJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17350 ST LUKES WAY
Mailing Address - Street 2:SUITE #320
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4100
Mailing Address - Country:US
Mailing Address - Phone:713-486-1625
Mailing Address - Fax:
Practice Address - Street 1:925 GESSNER RD STE 540
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2552
Practice Address - Country:US
Practice Address - Phone:713-486-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0983207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease