Provider Demographics
NPI:1528088127
Name:SADHU, ARCHANA REDDY (MD)
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:REDDY
Last Name:SADHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-0006
Mailing Address - Fax:713-790-2727
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-0006
Practice Address - Fax:713-790-2727
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75435207RE0101X
TXN6634207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1528088127OtherBLUE CROSS BLUE SHIELD
TX217498902Medicaid
TXP00986145OtherMEDICARE RR NEXGEN
TX217498901Medicaid
TX8CL458OtherBLUE CROSS BLUE SHIELD
TXP00905494OtherMEDICARE RR
CA00A754350Medicaid
TX217498903Medicaid
CAI22820Medicare UPIN
TX501406ZSWDMedicare PIN
CAWA75435AMedicare PIN
TXTXB110309Medicare PIN
CA00A754350Medicaid