Provider Demographics
NPI:1124287099
Name:ISAT, MASOUD (FNP)
Entity type:Individual
Prefix:
First Name:MASOUD
Middle Name:
Last Name:ISAT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4437
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4437
Mailing Address - Country:US
Mailing Address - Phone:512-300-2455
Mailing Address - Fax:512-891-0075
Practice Address - Street 1:3708 TAMIL ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-2540
Practice Address - Country:US
Practice Address - Phone:512-891-0056
Practice Address - Fax:512-891-0075
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily