MEDICARE: SUGAR LAND INFUSION LLC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1255058251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUGAR LAND INFUSION LLC

Provider Business Mailing Address
First Line	:	17003 SOUTHWEST FWY STE 300
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3480
Country	:	US
Telephone Number	:	832-261-4808
Fax Number	:	888-251-0385

Provider Business Practice Location Address
First Line	:	17003 SOUTHWEST FWY STE 300
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3480
Country	:	US
Telephone Number	:	832-261-4808
Fax Number	:	888-251-0385

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. SHAILENDRA SHUKLA
Credential	:
Telephone Number	:	832-261-4808

Provider Enumeration Date	:	10/20/2022
Last Update Date	:	10/20/2022

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Directions to “SUGAR LAND INFUSION LLC ” Practice Location

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