Provider Demographics
NPI:1457596991
Name:SASHI II PA
Entity Type:Organization
Organization Name:SASHI II PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LELIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-545-2054
Mailing Address - Street 1:1733 CURIE DR
Mailing Address - Street 2:STE. 205
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2909
Mailing Address - Country:US
Mailing Address - Phone:915-545-2054
Mailing Address - Fax:915-545-5437
Practice Address - Street 1:1733 CURIE DR
Practice Address - Street 2:STE. 205
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2910
Practice Address - Country:US
Practice Address - Phone:915-545-2054
Practice Address - Fax:915-545-5437
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LELIA T. GAINES MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-12
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4812302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092058901Medicaid
TX092058901Medicaid