Provider Demographics
NPI:1104813252
Name:SITTER, TIMOTHY CHRISTIAN (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CHRISTIAN
Last Name:SITTER
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 1:16811 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4728
Mailing Address - Country:US
Mailing Address - Phone:281-690-4678
Mailing Address - Fax:281-565-8808
Practice Address - Street 1:16811 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4728
Practice Address - Country:US
Practice Address - Phone:281-690-4678
Practice Address - Fax:281-565-8808
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4706207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610119705OtherUS DEPT OF LABOR
TX8BP172OtherBLUE CROSS BLUE SHIELD
TXP01055724OtherRR MEDICARE
TX129239311Medicaid
TX129239308Medicaid
TXP00734625OtherRAILROAD MEDICARE
TX129239307Medicaid
TX129239309Medicaid
TX129239306Medicaid
TX129239309Medicaid
TX8L13417Medicare PIN
TX8J1683Medicare PIN
TX610119705OtherUS DEPT OF LABOR
TX8BP172OtherBLUE CROSS BLUE SHIELD
TXP01055724OtherRR MEDICARE
TX129239307Medicaid
TXTXB151342Medicare PIN
TX311951YMVQMedicare PIN