Healthcare Provider Details

I. General information

NPI: 1235497413
Provider Name (Legal Business Name): SADIA YASSER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 SOUTH FRY ROAD SUITE 108
KATY TX
77450-2297
US

IV. Provider business mailing address

777 SOUTH FRY ROAD SUITE 108
KATY TX
77450-2297
US

V. Phone/Fax

Practice location:
  • Phone: 281-398-9711
  • Fax: 281-398-9641
Mailing address:
  • Phone: 281-398-9711
  • Fax: 281-398-9641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberN3398
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberN3398
License Number StateTX

VIII. Authorized Official

Name: FRANCISCO JAVIER RODRIGUEZ
Title or Position: ADMINISTRATOR
Credential: CMOM CMIS CMC
Phone: 281-398-9711