Provider Demographics
NPI:1154523488
Name:SIDHU, ANUPAM K (MD)
Entity type:Individual
Prefix:MRS
First Name:ANUPAM
Middle Name:K
Last Name:SIDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249 STE 390
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4349
Mailing Address - Country:US
Mailing Address - Phone:281-737-0899
Mailing Address - Fax:281-737-0892
Practice Address - Street 1:18220 STATE HIGHWAY 249 STE 390
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070
Practice Address - Country:US
Practice Address - Phone:281-737-0899
Practice Address - Fax:281-737-0892
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CJ368OtherBLUE CROSS BLUE SHIELD
TX214807402Medicaid
TX214807401Medicaid
TXP00895532OtherMEDICARE RR
TX1154523488OtherBLUE CROSS BLUE SHIELD
TX214807403Medicaid
TXTXB105238Medicare PIN
TX8CJ368OtherBLUE CROSS BLUE SHIELD