Provider Demographics
NPI:1720829492
Name:DESHPANDE, SANJAY PANKAJ (MBBS DCH DNB MNAMS)
Entity type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:PANKAJ
Last Name:DESHPANDE
Suffix:
Gender:M
Credentials:MBBS DCH DNB MNAMS
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1102 BATES AVE FL 11
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX482512080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases