=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790016897
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FERNANDO SARTI MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2010
-----------------------------------------------------
Last Update Date | 06/28/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4301 GARTH RD STE 301
-----------------------------------------------------
City | BAYTOWN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77521-3158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-427-6525
-----------------------------------------------------
Fax | 281-420-1272
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4301 GARTH RD STE 301
-----------------------------------------------------
City | BAYTOWN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77521-3158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-427-6525
-----------------------------------------------------
Fax | 281-420-1272
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | LINDA TALLENT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-427-6525
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | E3605
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------