Provider Demographics
NPI:1548477003
Name:MAKHDUMI, SANA (MD)
Entity type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:MAKHDUMI
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 1:5220 W UNIVERSITY DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7064
Mailing Address - Country:US
Mailing Address - Phone:469-800-5310
Mailing Address - Fax:469-800-5311
Practice Address - Street 1:5220 W UNIVERSITY DR STE 250
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7064
Practice Address - Country:US
Practice Address - Phone:469-800-5310
Practice Address - Fax:469-800-5315
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA69027207RR0500X
AL29753207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I669398Medicare PIN