Provider Demographics
NPI:1700196730
Name:WATSON, SARAH KENDALL (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KENDALL
Last Name:WATSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1176
Mailing Address - Street 2:
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484-1176
Mailing Address - Country:US
Mailing Address - Phone:936-931-3448
Mailing Address - Fax:936-931-3704
Practice Address - Street 1:17330 SPRING CYPRESS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4293
Practice Address - Country:US
Practice Address - Phone:281-373-3786
Practice Address - Fax:281-304-7786
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06527363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant