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General NPI Number Information
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NPI Number | 1336323203
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Entity Type | Organization
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Legal Business Name | MANJU SACHDEV, MD, PA
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/17/2009
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Provider Practice Location Address
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Address Line | 1908 N LAURENT ST STE 100
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City | VICTORIA
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State | TX
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Zip | 77901-5458
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Country | US
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Telephone | 361-575-5439
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Fax | 361-576-4219
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Provider Business Mailing Address
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Address Line | PO BOX 3468
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City | VICTORIA
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State | TX
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Zip | 77903-3468
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Country | US
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Telephone | 361-576-3680
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Fax | 361-576-4219
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Authorized Official
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Title or Position | OWNER
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Name | MANJU SACHDEV
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Credential | MD
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Telephone | 361-576-3680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K6704
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License Number State | TX
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