Provider Demographics
NPI:1376896332
Name:MAUNE, SARAH CRIM (CAA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CRIM
Last Name:MAUNE
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:CRIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7600 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1906
Practice Address - Country:US
Practice Address - Phone:713-790-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006666367H00000X
TX367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant