Healthcare Provider Details

I. General information

NPI: 1306426671
Provider Name (Legal Business Name): JOSHUA SACACIU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12312 INTERSTATE 45 N
WILLIS TX
77378-4717
US

IV. Provider business mailing address

909 FROSTWOOD DR STE 1.405
HOUSTON TX
77024-2301
US

V. Phone/Fax

Practice location:
  • Phone: 832-658-5550
  • Fax: 832-553-9850
Mailing address:
  • Phone: 713-338-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberV2254
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: