Basic Information
| Provider Information | |||||||||
| NPI: | 1679579882 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | JUDGE | ||||||||
| FirstName: | SATINDER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 E 10TH ST | ||||||||
| Address2: | |||||||||
| City: | WACONIA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553874552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524429770 | ||||||||
| FaxNumber: | 9524423620 | ||||||||
| Practice Location | |||||||||
| Address1: | 2701 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779015748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5125739181 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2005 | ||||||||
| LastUpdateDate: | 05/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | J9722 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 760639565 | 01 | TRICARE | OTHER | 5681234 | 01 | AETNA | OTHER | 050076452 | 01 | RAILROAD MEDICARE | OTHER | 89060Y | 01 | TX | BLUE CROSS OF TX | OTHER | 138420805 | 05 | TX | MEDICAID |