Organization
PEACH STATE MEDICAL PRACTICE, PC
Active
Other names
Kindbody of TX Medical Practice
Organization subpart
No
Provider details
NPI number
Authorized official
FAHIMEH SASAN DO (FOUNDING OBGYN)
(855) 563-2639
Entity
Organization
Contact information
Practice address
100 COLORADO ST, AUSTIN, TX 78701-4147
(855) 563-2639
Mailing address
333 S DESPLAINES ST STE 201, CHICAGO, IL 60661-5514
(855) 563-2639
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
Primary
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
Other
Enumeration date
04/15/2021
Last updated
05/20/2024
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