Provider Demographics
NPI:1992022081
Name:DHINDSA, TAJDEEP K (MD)
Entity type:Individual
Prefix:
First Name:TAJDEEP
Middle Name:K
Last Name:DHINDSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAJDEEP
Other - Middle Name:K
Other - Last Name:GREWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23900 KATY FWY STE W2100
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1323
Mailing Address - Country:US
Mailing Address - Phone:281-644-8111
Mailing Address - Fax:
Practice Address - Street 1:23900 KATY FWY STE W2100
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1323
Practice Address - Country:US
Practice Address - Phone:281-644-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57422-20207R00000X
TXU7111208M00000X, 207R00000X
WI57422208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100032215Medicaid