Provider Demographics
NPI:1043464720
Name:DEMOLA, SARA MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:MICHELLE
Last Name:DEMOLA
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:MC 1172
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-9066
Mailing Address - Fax:409-747-7319
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:MC 1172
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:409-772-9066
Practice Address - Fax:409-747-7319
Is Sole Proprietor?:No
Enumeration Date:2008-11-08
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP1-0032096208600000X
TXP1464208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery