Individual provider Active NPI

Marjan Asadifard

  • Physician Assistant
  • Sugar Land, TX
National Provider Identifier
1376211292
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4660 Sweetwater Blvd Ste 150
Sugar Land, TX 77479-3164
Phone
(281) 310-5935
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X TX Primary

Addresses

Primary practice location

4660 Sweetwater Blvd Ste 150
Sugar Land, TX 77479-3164

Mailing address

4660 Sweetwater Blvd Ste 150
Sugar Land, TX 77479-3164

Other practice location 1

4660 Sweetwater Blvd #150
Sugarland, TX 77479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1376211292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 SWEETWATER BLVD STE 150",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 SWEETWATER BLVD STE 150",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793164",
            "telephone_number": "281-310-5935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 Sweetwater Blvd #150",
            "address_purpose": "LOCATION",
            "city": "Sugarland",
            "state": "TX",
            "postal_code": "77479",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASADIFARD",
        "first_name": "MARJAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.