Healthcare Provider Details

I. General information

NPI: 1528988227
Provider Name (Legal Business Name): ESHA IMRAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MAPLE ST
NORWALK CT
06850-3815
US

IV. Provider business mailing address

26030 SUMMER SAVORY LN
KATY TX
77494-1277
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2571
  • Fax:
Mailing address:
  • Phone: 832-881-2261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: