Provider Demographics
NPI:1952362824
Name:SARDAR, WINFRED (MD)
Entity type:Individual
Prefix:
First Name:WINFRED
Middle Name:
Last Name:SARDAR
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:PO BOX 837
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:TX
Mailing Address - Zip Code:75459-0837
Mailing Address - Country:US
Mailing Address - Phone:903-487-2248
Mailing Address - Fax:903-487-2306
Practice Address - Street 1:801 E DEBBIE LN STE 103
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3185
Practice Address - Country:US
Practice Address - Phone:817-419-9048
Practice Address - Fax:817-419-3336
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6619207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170681407Medicaid
TX210824301Medicaid
TXI22053Medicare UPIN
TX170681407Medicaid
TX170681406Medicaid