Provider Demographics
NPI:1306989314
Name:SPRING PRIMARY CARE, PA
Entity type:Organization
Organization Name:SPRING PRIMARY CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:BINDU
Authorized Official - Middle Name:
Authorized Official - Last Name:SUDHAKARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-717-7825
Mailing Address - Street 1:21301 KUYKENDAHL RD
Mailing Address - Street 2:STE F
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388
Mailing Address - Country:US
Mailing Address - Phone:832-717-7825
Mailing Address - Fax:832-717-7826
Practice Address - Street 1:21301 KUYKENDAHL RD
Practice Address - Street 2:STE F
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:832-717-7825
Practice Address - Fax:832-717-7826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7107261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG83367Medicare UPIN