Healthcare Provider Details

I. General information

NPI: 1427719871
Provider Name (Legal Business Name): TODAY TELEMEDICINE PHYSICIAN ASSISTANT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 01/07/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31331 SHADOW BRANCH LANE
SPRING TX
77386
US

IV. Provider business mailing address

4470 W SUNSET BLVD STE 107 PMB 95926
LOS ANGELES CA
90027-6309
US

V. Phone/Fax

Practice location:
  • Phone: 407-902-0889
  • Fax: 800-964-0791
Mailing address:
  • Phone: 407-902-0889
  • Fax: 800-964-0791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: SARAH PURDY
Title or Position: OWNER
Credential: PHYSICIAN ASSISTANT
Phone: 407-902-8899