Provider Demographics
NPI:1699436568
Name:KASAM, QURATULAIN (PA-C)
Entity type:Individual
Prefix:
First Name:QURATULAIN
Middle Name:
Last Name:KASAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:KASAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6114 ALEXANDER FALLS LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4646
Mailing Address - Country:US
Mailing Address - Phone:281-236-2385
Mailing Address - Fax:
Practice Address - Street 1:6114 ALEXANDER FALLS LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4646
Practice Address - Country:US
Practice Address - Phone:281-236-2385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant