Healthcare Provider Details

I. General information

NPI: 1497326649
Provider Name (Legal Business Name): RINKOO SIDHU PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5899 PRESTON RD STE 404
FRISCO TX
75034-9590
US

IV. Provider business mailing address

821 N STATE ROAD 135
GREENWOOD IN
46142-1314
US

V. Phone/Fax

Practice location:
  • Phone: 214-618-0588
  • Fax: 877-345-4565
Mailing address:
  • Phone: 317-296-7707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number71011288A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number28225343A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: