Healthcare Provider Details

I. General information

NPI: 1780697292
Provider Name (Legal Business Name): JENNIFER SABIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16811 SOUTHWEST FWY
SUGAR LAND TX
77479
US

IV. Provider business mailing address

16811 SOUTHWEST FWY
SUGAR LAND TX
77479
US

V. Phone/Fax

Practice location:
  • Phone: 281-690-4678
  • Fax: 281-565-8808
Mailing address:
  • Phone: 281-690-4678
  • Fax: 281-565-8808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA03763
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: