Healthcare Provider Details
I. General information
NPI: 1134458003
Provider Name (Legal Business Name): SANJAI ISAAC MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/23/2009
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3308 PRESTON RD STE 350-287
PLANO TX
75093-7453
US
IV. Provider business mailing address
3308 PRESTON RD STE 350-287
PLANO TX
75093-7453
US
V. Phone/Fax
- Phone: 214-471-5975
- Fax: 866-476-1204
- Phone: 214-471-5975
- Fax: 866-476-1204
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name:
SANJAI
ISAAC
Title or Position: OWNER
Credential: MD
Phone: 214-471-5975