Provider Demographics
NPI:1134303183
Name:MICHAEL ESANTSI MD PA
Entity Type:Organization
Organization Name:MICHAEL ESANTSI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESANTSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-477-3393
Mailing Address - Street 1:PO BOX 690362
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-0362
Mailing Address - Country:US
Mailing Address - Phone:281-477-3393
Mailing Address - Fax:281-477-3477
Practice Address - Street 1:18220 STATE HIGHWAY 249
Practice Address - Street 2:SUITE 350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-477-3393
Practice Address - Fax:281-477-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106334903Medicaid
TX106334903Medicaid
TXG31735Medicare UPIN
TX106334903Medicaid