Provider Demographics
NPI:1508102542
Name:FARNIA, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FARNIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10496 KATY FWY STE 101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-5269
Mailing Address - Country:US
Mailing Address - Phone:346-571-7500
Mailing Address - Fax:713-492-2440
Practice Address - Street 1:10496 KATY FWY STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043
Practice Address - Country:US
Practice Address - Phone:346-571-7500
Practice Address - Fax:713-492-2440
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3893-023363A00000X
TXPA08108363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1508102542Medicaid
TX510190ZU13Medicare PIN
WI1508102542Medicaid