Provider Demographics
NPI:1144647140
Name:ZAIDI, SANAM (PA-C)
Entity type:Individual
Prefix:
First Name:SANAM
Middle Name:
Last Name:ZAIDI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 E HEBRON PARKWAY
Mailing Address - Street 2:BLDG 500
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2699
Mailing Address - Country:US
Mailing Address - Phone:1972-478-5538
Mailing Address - Fax:
Practice Address - Street 1:3465 W WALNUT ST
Practice Address - Street 2:#225
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7153
Practice Address - Country:US
Practice Address - Phone:972-272-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08953363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical