Provider Demographics
NPI:1588939813
Name:DURHAM, SARAH ANGELA (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANGELA
Last Name:DURHAM
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 1:444 FM 1959 RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-5416
Mailing Address - Country:US
Mailing Address - Phone:281-481-9400
Mailing Address - Fax:281-892-2459
Practice Address - Street 1:444 FM 1959 RD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5416
Practice Address - Country:US
Practice Address - Phone:281-481-9400
Practice Address - Fax:281-892-2459
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004706363A00000X
TXPA08599363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant