Provider Demographics
NPI:1679250245
Name:SUNBEAM DIAGNOSTICS & WELLNESS LLC
Entity Type:Organization
Organization Name:SUNBEAM DIAGNOSTICS & WELLNESS LLC
Other - Org Name:SUNBEAM DIAGNOSTICS & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ONER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-265-2605
Mailing Address - Street 1:1015 COVE CREST TRL
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-7179
Mailing Address - Country:US
Mailing Address - Phone:832-265-2605
Mailing Address - Fax:
Practice Address - Street 1:13630 BEAMER RD STE 125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6038
Practice Address - Country:US
Practice Address - Phone:832-265-2605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty