Healthcare Provider Details

I. General information

NPI: 1447260518
Provider Name (Legal Business Name): MICHAEL ESANTSI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18220 STATE HIGHWAY 249 SUITE 350
HOUSTON TX
77070-4347
US

IV. Provider business mailing address

PO BOX 690362
HOUSTON TX
77269-0362
US

V. Phone/Fax

Practice location:
  • Phone: 281-477-3393
  • Fax: 281-477-3477
Mailing address:
  • Phone: 281-477-3393
  • Fax: 281-477-3477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK0737
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: