Provider Demographics
NPI:1750359568
Name:SARMIENTO, DON JOSE (DO)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:JOSE
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:HOUSTON METHODIST PRIMARY CARE GROUP
Mailing Address - Street 2:4015 INTERSTATE 45 NORTH, STE 100
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-0000
Mailing Address - Country:US
Mailing Address - Phone:936-270-4600
Mailing Address - Fax:936-856-8429
Practice Address - Street 1:HOUSTON METHODIST PRIMARY CARE GROUP
Practice Address - Street 2:4015 INTERSTATE 45 NORTH, STE 100
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-0000
Practice Address - Country:US
Practice Address - Phone:936-270-4600
Practice Address - Fax:936-856-8429
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188323301Medicaid
TX8GD218OtherBCBS
TXI10721Medicare UPIN
TX188323301Medicaid
TXTXB103710Medicare PIN
GAP00397282Medicare PIN
TX8GD218OtherBCBS