Provider Demographics
NPI:1699345009
Name:SALA HEALTH HOUSE CALL LLC
Entity type:Organization
Organization Name:SALA HEALTH HOUSE CALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ABUSOMWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-896-6144
Mailing Address - Street 1:11625 CUSTER RD STE 110-127
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8783
Mailing Address - Country:US
Mailing Address - Phone:972-896-6144
Mailing Address - Fax:
Practice Address - Street 1:12436 DAISY LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0716
Practice Address - Country:US
Practice Address - Phone:972-896-6144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty