Provider Demographics
NPI:1245190677
Name:SASSON, JOHN S (AGACNP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:SASSON
Suffix:
Gender:M
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17490 HIGHWAY 3 STE A300
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-3602
Mailing Address - Country:US
Mailing Address - Phone:281-724-9940
Mailing Address - Fax:
Practice Address - Street 1:17490 HIGHWAY 3 STE A300
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-3602
Practice Address - Country:US
Practice Address - Phone:281-724-9940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1217536363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care