Provider Demographics
NPI:1427093582
Name:WASHA, SARA (APRN, BC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:WASHA
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8511 S SAM HOUSTON PKWY E
Mailing Address - Street 2:101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4857
Mailing Address - Country:US
Mailing Address - Phone:713-343-2301
Mailing Address - Fax:
Practice Address - Street 1:8511 S SAM HOUSTON PKWY E
Practice Address - Street 2:101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4857
Practice Address - Country:US
Practice Address - Phone:713-343-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652660363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196464501Medicaid
TX8K9408Medicare PIN