Provider Demographics
NPI:1174581979
Name:SINGH, KULDEEP (MD)
Entity type:Individual
Prefix:DR
First Name:KULDEEP
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 W 15TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5860
Mailing Address - Country:US
Mailing Address - Phone:972-943-1916
Mailing Address - Fax:972-943-1917
Practice Address - Street 1:4104 W 15TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5860
Practice Address - Country:US
Practice Address - Phone:972-943-1916
Practice Address - Fax:972-943-1917
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0465207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH31562Medicare UPIN