MEDICARE: SUGAR LAND ENT AND SLEEP CENTER, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	L9330	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902927270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUGAR LAND ENT AND SLEEP CENTER, PA

Provider Business Mailing Address
First Line	:	6921 BRISBANE CT STE 210
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7094
Country	:	US
Telephone Number	:	281-556-1102
Fax Number	:	281-556-1340

Provider Business Practice Location Address
First Line	:	6921 BRISBANE CT STE 210
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7094
Country	:	US
Telephone Number	:	281-556-1102
Fax Number	:	281-556-1340

Authorized Official
Title or Position	:	SOLE PROVIDER
Name	:	DR. JAMES J. LUDWICK
Credential	:	MD
Telephone Number	:	281-556-1102

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	02/02/2021

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