Healthcare Provider Details

I. General information

NPI: 1245934330
Provider Name (Legal Business Name): SASHA AJAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27700 NW FREEWAY STE 601
CYPRESS TX
77433-7202
US

IV. Provider business mailing address

930 FROSTWOOD DR STE 2.200
HOUSTON TX
77024-2450
US

V. Phone/Fax

Practice location:
  • Phone: 346-231-6850
  • Fax: 346-231-6851
Mailing address:
  • Phone: 713-338-5502
  • Fax: 713-338-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberW4041
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberW4041
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: