Provider Demographics
NPI:1659106615
Name:GRAY, SASHA JASMINE (PA-C)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:JASMINE
Last Name:GRAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 SUMMER ST APT 630
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-4747
Mailing Address - Country:US
Mailing Address - Phone:409-939-5467
Mailing Address - Fax:
Practice Address - Street 1:1441 WOODSTEAD CT
Practice Address - Street 2:STE 300
Practice Address - City:WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-374-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA18441363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant