Basic Information
| Provider Information | |||||||||
| NPI: | 1750489845 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GATUMU | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3355 W ALABAMA ST STE 195 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770981722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328956255 | ||||||||
| FaxNumber: | 2816482200 | ||||||||
| Practice Location | |||||||||
| Address1: | 3355 W ALABAMA ST STE 195 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770981722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325956255 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 01/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | S8559 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | MD428276 | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 1017978910001 | 05 | PA | MEDICAID |