| Josier M. Nisnisan Md, Pllc | |
|
1400 Creek Way Dr Ste 201a Sugar Land TX 77478-4073 | |
| (281) 201-2096 | |
| (281) 759-6447 |
| Full Name | Josier M. Nisnisan Md, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1400 Creek Way Dr Ste 201a, Sugar Land, Texas |
| Authorized Official Name and Position | Josier M. Nisnisan (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2812012096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Josier M. Nisnisan Md, Pllc 1400 Creek Way Dr Ste 201a Sugar Land TX 77478-4073 Ph: (281) 201-2096 | Josier M. Nisnisan Md, Pllc 1400 Creek Way Dr Ste 201a Sugar Land TX 77478-4073 Ph: (281) 201-2096 |
| NPI Number | 1841229911 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 09/25/2023 |
| Medicare PECOS PAC ID | 0941262158 |
|---|---|
| Medicare Enrollment ID | O20041030000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841229911 | NPI | - | NPPES |
| 0079LB | Other | TX | BC/BS |
| 168440901 | Medicaid | TX | |
| 11047209 | Other | TX | CAQH PROVIDER NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L4079 (Texas) | Primary |
| Provider Name | Josier M Nisnisan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639391527 PECOS PAC ID: 6204898414 Enrollment ID: I20041103000399 |
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