Individual provider Active NPI

Vlad Constantin Sandulache, M.D

  • Otolaryngology Physician
  • Houston, TX
National Provider Identifier
1679726939
Registry record updated Nov 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
Q2705 Issued in TX
Practice address
1977 Butler Blvd # E5.200
Houston, TX 77030-4101
Phone
(713) 798-5900
Fax
(713) 798-5841
NPI assigned
Oct 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X BP10030820 TX
Otolaryngology Physician 207Y00000X Q2705 TX Primary

Addresses

Primary practice location

1977 Butler Blvd # E5.200
Houston, TX 77030-4101

Mailing address

P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other practice location 1

1515 Holcombe Blvd
Houston, TX 77030-4009
Phone (713) 792-6161

Other identifiers 1

IdentifierTypeStateIssuer
346690601MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vsandulache11927@bcm.ghhdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150612000083 TX Practitioner - Otolaryngology 5496066789 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10030820TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Apr 1, 2016 Accepting new patients
Baylor College of Medicine CurrentSince Apr 1, 2016 Accepting new patients
Baylor College of Medicine CurrentSince Apr 1, 2016 Accepting new patients
Baylor College of Medicine CurrentSince Apr 1, 2016 Accepting new patients

Locations

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

1977 Butler Blvd
#E5200
Houston, TX 77030
Phone (713) 798-5900

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606435200000",
    "number": "1679726939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 BUTLER BLVD # E5.200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "713-798-5900",
            "fax_number": "713-798-5841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304009",
            "country_code": "US",
            "telephone_number": "713-792-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDULACHE",
        "first_name": "VLAD",
        "middle_name": "CONSTANTIN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-30",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "BP10030820",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "Q2705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346690601",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vsandulache11927@bcm.ghhdirect.net",
            "affiliation": "N",
            "address_1": "1977 Butler Blvd # E5.200",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770304101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.