| Anupam Md Pa | |
|
3320 Plainview St Pasadena TX 77504-1906 | |
| (409) 539-9921 | |
| Not Available |
| Full Name | Anupam Md Pa |
|---|---|
| Speciality | Pediatrics |
| Location | 3320 Plainview St, Pasadena, Texas |
| Authorized Official Name and Position | Ashu Sodhi Syal (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4095399921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anupam Md Pa Po Box 1666 La Marque TX 77568-1666 Ph: (409) 539-9921 | Anupam Md Pa 3320 Plainview St Pasadena TX 77504-1906 Ph: (409) 539-9921 |
| NPI Number | 1184048449 |
|---|---|
| Provider Enumeration Date | 02/07/2014 |
| Last Update Date | 10/31/2014 |
| Medicare PECOS PAC ID | 3779803440 |
|---|---|
| Medicare Enrollment ID | O20150520001032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184048449 | NPI | - | NPPES |
| 193755901 | Medicaid | TX | |
| 3352759-03 | Medicaid | TX | |
| 4876619 | Medicaid | TX | |
| 3352759-01 | Medicaid | TX | |
| 3352759-02 | Medicaid | TX | |
| 1124064779 | Other | TX | PROVIDER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | M5532 (Texas) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | M5532 (Texas) | Secondary |
| 208000000X | Pediatrics | M5532 (Texas) | Primary |
| Provider Name | Ashu Syal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124064779 PECOS PAC ID: 5294055976 Enrollment ID: I20150520001632 |
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