| Sandstone Family Medicine | |
|
1803 W White Oak Ter Ste B Conroe TX 77304-3675 | |
| (713) 825-8670 | |
| (936) 582-0410 |
| Full Name | Sandstone Family Medicine |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1803 W White Oak Ter Ste B, Conroe, Texas |
| Authorized Official Name and Position | Tony Deramus (MANAGEMENT) |
| Authorized Official Contact | 7138258670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandstone Family Medicine 1803 W White Oak Ter Ste B Conroe TX 77304-3675 Ph: (713) 825-8670 | Sandstone Family Medicine 1803 W White Oak Ter Ste B Conroe TX 77304-3675 Ph: (713) 825-8670 |
| NPI Number | 1144717968 |
|---|---|
| Provider Enumeration Date | 04/17/2018 |
| Last Update Date | 12/07/2018 |
| Medicare PECOS PAC ID | 6406185545 |
|---|---|
| Medicare Enrollment ID | O20190916000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144717968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | M4108 (Texas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Michael A Kaplan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740259001 PECOS PAC ID: 7012953276 Enrollment ID: I20050628001397 |
| Provider Name | Amanda R Rosales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114272887 PECOS PAC ID: 4284858226 Enrollment ID: I20140613002166 |
| Provider Name | Codi Danielle Leggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033685748 PECOS PAC ID: 2961740790 Enrollment ID: I20190220002106 |
| Provider Name | Meagan Michelle Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366023319 PECOS PAC ID: 6305221425 Enrollment ID: I20220909002291 |
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