Healthcare Provider Details

I. General information

NPI: 1538285960
Provider Name (Legal Business Name): KAREN CINDY JAGASSAR-SOOKLAL P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12121 RICHMOND AVE SUITE 325
HOUSTON TX
77082-2432
US

IV. Provider business mailing address

12121 RICHMOND AVE SUITE 325
HOUSTON TX
77082-2432
US

V. Phone/Fax

Practice location:
  • Phone: 281-496-1700
  • Fax: 281-496-9081
Mailing address:
  • Phone: 281-496-1700
  • Fax: 281-496-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA03034
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: