Provider Demographics
NPI:1902927270
Name:SUGAR LAND ENT AND SLEEP CENTER, PA
Entity Type:Organization
Organization Name:SUGAR LAND ENT AND SLEEP CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-556-1102
Mailing Address - Street 1:6921 BRISBANE CT STE 210
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7094
Mailing Address - Country:US
Mailing Address - Phone:281-556-1102
Mailing Address - Fax:281-556-1340
Practice Address - Street 1:6921 BRISBANE CT STE 210
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7094
Practice Address - Country:US
Practice Address - Phone:281-556-1102
Practice Address - Fax:281-556-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9330207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1677759Medicaid
TX00823ZMedicare PIN
TX1677759Medicaid
8C2073Medicare PIN
I15072Medicare UPIN