Provider Demographics
NPI:1326386160
Name:KEYES, SARAH-ANN KATHLEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH-ANN
Middle Name:KATHLEEN
Last Name:KEYES
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 1:7575 SAN FELIPE ST
Mailing Address - Street 2:SUITE 155
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1711
Mailing Address - Country:US
Mailing Address - Phone:613-266-9955
Mailing Address - Fax:
Practice Address - Street 1:7575 SAN FELIPE ST
Practice Address - Street 2:SUITE 155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1711
Practice Address - Country:US
Practice Address - Phone:613-266-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08270363A00000X
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8754NUOtherBLUE CROSS BLUE SHIELD
TX341737001Medicaid
TX8264NDOtherBLUE CROSS BLUE SHIELD
TX8754NUOtherBLUE CROSS BLUE SHIELD
TX296358YMVQMedicare PIN