MEDICARE: TASA, P.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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1174641088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TASA, P.C.

Provider Business Mailing Address
First Line	:	14770 MEMORIAL # 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-5252
Country	:	US
Telephone Number	:	281-493-5535
Fax Number	:	281-493-3353

Provider Business Practice Location Address
First Line	:	14755 NORTH FWY STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-6508
Country	:	US
Telephone Number	:	281-876-2500
Fax Number	:	281-876-2574

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RAMESH SADEGHIAN
Credential	:	D.C.
Telephone Number	:	281-977-8354

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	12/08/2016

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