Provider Demographics
NPI:1962792945
Name:YAHYA SARDANI, MD, PA
Entity type:Organization
Organization Name:YAHYA SARDANI, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YAHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-789-1430
Mailing Address - Street 1:123 W MILE 3 RD
Mailing Address - Street 2:SUITE A-101
Mailing Address - City:PALMHURST
Mailing Address - State:TX
Mailing Address - Zip Code:78573-1633
Mailing Address - Country:US
Mailing Address - Phone:956-378-4863
Mailing Address - Fax:956-378-4864
Practice Address - Street 1:123 W MILE 3 RD
Practice Address - Street 2:SUITE A-101
Practice Address - City:PALMHURST
Practice Address - State:TX
Practice Address - Zip Code:78573-1633
Practice Address - Country:US
Practice Address - Phone:956-378-4863
Practice Address - Fax:956-378-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1439208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1619095676OtherNPI TYPE 1
TX1768673Medicaid