Provider Demographics
NPI:1952440380
Name:MANSARAY-PEAY, SAIBATU ISAT (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SAIBATU
Middle Name:ISAT
Last Name:MANSARAY-PEAY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:17628 DANSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5174
Mailing Address - Country:US
Mailing Address - Phone:910-391-2523
Mailing Address - Fax:
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:DARNALL ARMY MEDICAL CENTER
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5095
Practice Address - Country:US
Practice Address - Phone:254-618-8340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1068233363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant