Provider Demographics
NPI:1972512325
Name:SULE, SANDEEP DILEEP (MD)
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:DILEEP
Last Name:SULE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 MERIT DR
Mailing Address - Street 2:SUITE 1060
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2202
Mailing Address - Country:US
Mailing Address - Phone:972-960-2950
Mailing Address - Fax:972-960-2838
Practice Address - Street 1:12221 MERIT DR
Practice Address - Street 2:SUITE 1060
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2202
Practice Address - Country:US
Practice Address - Phone:972-960-2950
Practice Address - Fax:972-960-2838
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND11471207Y00000X
TXTEMPORARY207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000094591Medicare ID - Type Unspecified