| Sagestar Health & Wellness Clinic Pllc | |
|
2626 S Loop W Ste 430 Houston TX 77054-2649 | |
| (713) 560-1459 | |
| Not Available |
| Full Name | Sagestar Health & Wellness Clinic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2626 S Loop W Ste 430, Houston, Texas |
| Authorized Official Name and Position | Saramma Mathew Russell (PRESIDENT/CEO/PROVIDER) |
| Authorized Official Contact | 7135601459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sagestar Health & Wellness Clinic Pllc 4918 Beekman Dr Missouri City TX 77459-1209 Ph: (713) 560-1459 | Sagestar Health & Wellness Clinic Pllc 2626 S Loop W Ste 430 Houston TX 77054-2649 Ph: (713) 560-1459 |
| NPI Number | 1164140984 |
|---|---|
| Provider Enumeration Date | 08/17/2022 |
| Last Update Date | 09/14/2022 |
| Medicare PECOS PAC ID | 7911383419 |
|---|---|
| Medicare Enrollment ID | O20221006003181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164140984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Saramma Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427180124 PECOS PAC ID: 1254516107 Enrollment ID: I20110419000971 |
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