Provider Demographics
NPI:1740264894
Name:PHILIP, SINDHU E (DO)
Entity type:Individual
Prefix:
First Name:SINDHU
Middle Name:E
Last Name:PHILIP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 OLYMPIA LN
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5071
Mailing Address - Country:US
Mailing Address - Phone:214-934-4123
Mailing Address - Fax:
Practice Address - Street 1:541 W MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3628
Practice Address - Country:US
Practice Address - Phone:469-702-6633
Practice Address - Fax:469-702-6636
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47752208000000X
TXL7846208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164833902Medicaid