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General NPI Number Information
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NPI Number | 1477238970
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Entity Type | Organization
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Legal Business Name | SANATIVE HEALTHCARE LLC
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 17319 E SUMMER ROSE CT
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City | CYPRESS
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State | TX
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Zip | 77429-6723
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Country | US
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Telephone | 786-253-2074
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Fax |
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Provider Business Mailing Address
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Address Line | 17319 E SUMMER ROSE CT
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City | CYPRESS
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State | TX
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Zip | 77429-6723
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Country | US
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Telephone | 786-253-2074
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Fax |
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | SANA KAUSAR SHAMJI-MUKHI
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Credential | MD
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Telephone | 786-253-2074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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