MEDICARE: SUNBEAM DIAGNOSTICS & WELLNESS 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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1679250245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNBEAM DIAGNOSTICS & WELLNESS LLC

Provider Business Mailing Address
First Line	:	1015 COVE CREST TRL
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-7179
Country	:	US
Telephone Number	:	832-265-2605
Fax Number	:

Provider Business Practice Location Address
First Line	:	13630 BEAMER RD STE 125
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-6038
Country	:	US
Telephone Number	:	832-265-2605
Fax Number	:

Authorized Official
Title or Position	:	ONER/NURSE PRACTITIONER
Name	:	SHARRON ALEXANDER
Credential	:
Telephone Number	:	832-265-2605

Provider Enumeration Date	:	07/05/2023
Last Update Date	:	07/14/2023

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