Provider Demographics
NPI:1447330097
Name:ALFREDO SARDINAS MD PA
Entity type:Organization
Organization Name:ALFREDO SARDINAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-869-0850
Mailing Address - Street 1:427 W 20TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2400
Mailing Address - Country:US
Mailing Address - Phone:713-869-0850
Mailing Address - Fax:713-869-0336
Practice Address - Street 1:427 W 20TH ST STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2400
Practice Address - Country:US
Practice Address - Phone:713-869-0850
Practice Address - Fax:713-869-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2472207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1312837-03Medicaid
TX1312837-03Medicaid
TX0094AMMedicare ID - Type Unspecified
TX=========OtherTAX ID NUMBER