MEDICARE: SHIVA SATISH M.D.

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	208M00000X	Hospitalist Physician	J6232	TX
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	J6232	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P01071853	OTHER	TX	RR MEDICARE
4	TXB151471	OTHER	TX	MEDICARE
5	P00959960	OTHER	TX	RR MEDICARE
6	TXB130432	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8CW374	OTHER	TX	BCBS TX
2	8DK799	OTHER	TX	BCBS TX
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	0657304	OTHER	TX	CIGNA
11	5164045	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1629099635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIVA SATISH M.D.

Provider Business Mailing Address
First Line	:	16605 SOUTHWEST FWY
Second Line	:	SUITE 175
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-0003
Country	:	US
Telephone Number	:	713-777-5334
Fax Number	:	713-429-5207

Provider Business Practice Location Address
First Line	:	16605 SOUTHWEST FWY
Second Line	:	SUITE 175
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-0003
Country	:	US
Telephone Number	:	713-777-5334
Fax Number	:	713-429-5207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	09/28/2022

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Directions to “ SHIVA SATISH M.D.” Practice Location

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