1083703656 NPI number — DR. SANJAY KUMAR SHARMA M.D.

Table of content: DR. SANJAY KUMAR SHARMA M.D. (NPI 1083703656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083703656 NPI number — DR. SANJAY KUMAR SHARMA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARMA
Provider First Name:
SANJAY
Provider Middle Name:
KUMAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083703656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 N IH 35
Provider Second Line Business Mailing Address:
SUTIE 320
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78701-1926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-324-8320
Provider Business Mailing Address Fax Number:
512-324-8323

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 N IH 35
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78701-1926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-324-8320
Provider Business Practice Location Address Fax Number:
512-324-8323
Provider Enumeration Date:
10/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2082S0105X , with the licence number:  K6503 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8AJ353 . This is a "BCBS INDIVIDUAL NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 162500602 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com