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NPI Code Detail

MEDICARE: SANDEE W ROQUEMORE PA-C

MEDICARE: SANDEE W ROQUEMORE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA00422TX

General Provider Information

NPI Number : 1093739872
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDEE W ROQUEMORE PA-C
Provider Business Mailing Address
First Line : 4700 W SAM HOUSTON PKWY N STE 220
Second Line :
City : HOUSTON
State : TX
Zip : 77041-8224
Country : US
Telephone Number : 713-402-7824
Fax Number : 713-570-0196
Provider Business Practice Location Address
First Line : 4700 W SAM HOUSTON PKWY N STE 220
Second Line :
City : HOUSTON
State : TX
Zip : 77041-8224
Country : US
Telephone Number : 713-402-7824
Fax Number : 713-570-0196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 08/22/2024

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Directions to “ SANDEE W ROQUEMORE PA-C” Practice Location

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