Healthcare Provider Details

I. General information

NPI: 1245934330
Provider Name (Legal Business Name): SASHA AJAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14023 SOUTHWEST FWY
SUGAR LAND TX
77478-3550
US

IV. Provider business mailing address

14023 SOUTHWEST FWY
SUGAR LAND TX
77478-3550
US

V. Phone/Fax

Practice location:
  • Phone: 281-325-4100
  • Fax: 281-325-4292
Mailing address:
  • Phone: 281-325-4100
  • Fax: 281-325-4292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberW4041
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: