Provider Demographics
NPI:1003666348
Name:SAZONOVA, YAROSLAVA YURYEVNA (NP)
Entity Type:Individual
Prefix:
First Name:YAROSLAVA
Middle Name:YURYEVNA
Last Name:SAZONOVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:YAROSLAVA
Other - Middle Name:YURYEVNA
Other - Last Name:TINH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:919 REINICKE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5191
Mailing Address - Country:US
Mailing Address - Phone:713-396-9036
Mailing Address - Fax:
Practice Address - Street 1:4101 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5294
Practice Address - Country:US
Practice Address - Phone:713-797-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137571363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care