Provider Demographics
NPI:1366556441
Name:BEDI, SAGAR (MD)
Entity type:Individual
Prefix:DR
First Name:SAGAR
Middle Name:
Last Name:BEDI
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:DEPT 960390
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0390
Mailing Address - Country:US
Mailing Address - Phone:800-684-1573
Mailing Address - Fax:405-844-1794
Practice Address - Street 1:231 S COLLINS RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4624
Practice Address - Country:US
Practice Address - Phone:972-892-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91788207Q00000X, 207P00000X
TXP4927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM 53832HMedicaid
CA00A917880Medicaid
CAB0601SMedicare PIN
CA00A917880Medicaid
I40726Medicare UPIN
CA00A917882Medicare PIN
ZZZ14573ZMedicare ID - Type Unspecified