Provider Demographics
NPI:1295581031
Name:CARPE SANA MEDICAL MANAGEMENT, LLC
Entity type:Organization
Organization Name:CARPE SANA MEDICAL MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-441-9272
Mailing Address - Street 1:128 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-1705
Mailing Address - Country:US
Mailing Address - Phone:469-441-9272
Mailing Address - Fax:
Practice Address - Street 1:128 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:TX
Practice Address - Zip Code:76273-1705
Practice Address - Country:US
Practice Address - Phone:469-441-9272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty