Provider Demographics
NPI:1639159833
Name:ISAAC, SANJAI (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJAI
Middle Name:
Last Name:ISAAC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 PRESTON RD 350-287
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7453
Mailing Address - Country:US
Mailing Address - Phone:214-471-5975
Mailing Address - Fax:866-476-1204
Practice Address - Street 1:1000 WOODCOCK RD STE 120
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3509
Practice Address - Country:US
Practice Address - Phone:407-792-1968
Practice Address - Fax:407-641-5179
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6498207L00000X, 207P00000X
FLME158582207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200217850AMedicaid
FL116830900Medicaid
TX14005729Medicaid
TXF93893Medicare UPIN
TX8K2325Medicare PIN
TX8F24395Medicare PIN
TX8G3226Medicare PIN