Healthcare Provider Details

I. General information

NPI: 1962792945
Provider Name (Legal Business Name): YAHYA SARDANI, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 W MILE 3 RD SUITE A-101
PALMHURST TX
78573-1633
US

IV. Provider business mailing address

123 W MILE 3 RD SUITE A-101
PALMHURST TX
78573-1633
US

V. Phone/Fax

Practice location:
  • Phone: 956-378-4863
  • Fax: 956-378-4864
Mailing address:
  • Phone: 956-378-4863
  • Fax: 956-378-4864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM1439
License Number StateTX

VIII. Authorized Official

Name: YAHYA SARDANI
Title or Position: DIRECTOR
Credential: MD
Phone: 956-789-1430