Anupam MD PA
Organization Active NPI Pediatrics Physician · Pasadena, TX
NPI 1184048449 · NPPES record last updated Oct 31, 2014
Key facts
- NPI
- 1184048449
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- M5532 (TX)
- Legal business name
- ANUPAM MD PA
- Practice address
- 3320 Plainview St
Pasadena, TX 77504-1906 - Phone
- (409) 539-9921
- NPI assigned
- Feb 7, 2014
- Organization subpart
- No
Authorized official
- Name
- Ashu Sodhi Syal, MD
- Title
- Clinical Director
- Phone
- (409) 539-9921
Practitioners 2
-
Ashu Syal, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150520001032 | TX | Part B Supplier - Clinic/Group Practice | 3779803440 |
Receives reassigned benefits from 2 practitioners Practice locations: Webster, TX; Pasadena, TX; Houston, TX; Corpus Christi, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | M5532 | TX | Yes |
| Clinic/Center | 261Q00000X | M5532 | TX | |
| Multi-Specialty Clinic/Center | 261QM1300X | M5532 | TX |
Addresses
Primary practice location
3320 Plainview St
Pasadena, TX 77504-1906
Mailing address
PO Box 1666
La Marque, TX 77568-1666
Phone (409) 539-9921
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193755901 | Medicaid | TX | |
| 3352759-03 | Medicaid | TX | |
| 4876619 | Medicaid | TX | |
| 3352759-01 | Medicaid | TX | |
| 3352759-02 | Medicaid | TX | |
| 1124064779 | Other | TX | PROVIDER NPI |
Other names
- NAG Clinics
Other providers in Pasadena, TX
- Angeles Lai Zayas
- Angelopolis Home Health Services
- Angels Pharmacy
- Anila Shah DDS PA
- Kim Raydon Antunez
- Anupam Urgent Care
- Agnes C Anyalebechi
- Apollo Healthcare at Bay Area, LP
- William O Appiah
- John Paul Aquilina
All providers in Pasadena, TX · Pediatrics Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.