Provider Demographics
NPI:1730180498
Name:SINGH, GEETA (MD)
Entity type:Individual
Prefix:
First Name:GEETA
Middle Name:
Last Name:SINGH
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 1:300 MARVIN HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-3480
Mailing Address - Country:US
Mailing Address - Phone:409-383-1355
Mailing Address - Fax:409-384-7276
Practice Address - Street 1:300 MARVIN HANCOCK DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-3480
Practice Address - Country:US
Practice Address - Phone:409-383-1355
Practice Address - Fax:409-384-7276
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030592202Medicaid
TX030592202Medicaid
TX0052RMedicare ID - Type UnspecifiedGROUP
TX8144N2Medicare ID - Type UnspecifiedINDIVIDUAL