MEDICARE: SUGAR LAND GERIATRICS & MEDICAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner
2	207R00000X	Internal Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00412Y	OTHER	TX	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184653008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUGAR LAND GERIATRICS & MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	3531 TOWN CENTER BLVD S STE 101
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2591
Country	:	US
Telephone Number	:	281-491-3225
Fax Number	:	281-491-1702

Provider Business Practice Location Address
First Line	:	3531 TOWN CENTER BLVD S STE 101
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2591
Country	:	US
Telephone Number	:	281-491-3225
Fax Number	:	281-491-1702

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SONAL R PATEL
Credential	:
Telephone Number	:	281-491-3225

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	05/04/2026

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Directions to “SUGAR LAND GERIATRICS & MEDICAL ASSOCIATES ” Practice Location

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