| Sahasra Medical Clinic | |
|
4141 Southwest Fwy Ste 510 Houston TX 77027-7334 | |
| (832) 699-9734 | |
| (281) 710-6222 |
| Full Name | Sahasra Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4141 Southwest Fwy Ste 510, Houston, Texas |
| Authorized Official Name and Position | Iesha Ishea Grant (OWNER) |
| Authorized Official Contact | 5047620245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sahasra Medical Clinic 1403 Bodenger Blvd New Orleans LA 70114-6001 Ph: (832) 699-9734 | Sahasra Medical Clinic 4141 Southwest Fwy Ste 510 Houston TX 77027-7334 Ph: (832) 699-9734 |
| NPI Number | 1073779054 |
|---|---|
| Provider Enumeration Date | 07/30/2008 |
| Last Update Date | 06/17/2020 |
| Medicare PECOS PAC ID | 7113074311 |
|---|---|
| Medicare Enrollment ID | O20090403000442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073779054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Iesha Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275709412 PECOS PAC ID: 4385791599 Enrollment ID: I20090403000456 |
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