Provider Demographics
NPI:1164740221
Name:EDEIKEN, SARA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:M
Last Name:EDEIKEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4201 GARTH RD STE 111
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3154
Mailing Address - Country:US
Mailing Address - Phone:832-556-6625
Mailing Address - Fax:832-556-6650
Practice Address - Street 1:4201 GARTH RD STE 111
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3154
Practice Address - Country:US
Practice Address - Phone:832-556-6625
Practice Address - Fax:832-556-6650
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2023-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4824652086S0129X
TXS02802086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery