Provider Demographics
NPI:1790089480
Name:HUSTON, SARAH ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HUSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N VAN DORN ST
Mailing Address - Street 2:STE 109
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1626
Mailing Address - Country:US
Mailing Address - Phone:703-933-0555
Mailing Address - Fax:703-933-0999
Practice Address - Street 1:2500 N VAN DORN ST
Practice Address - Street 2:STE 109
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1626
Practice Address - Country:US
Practice Address - Phone:703-933-0555
Practice Address - Fax:703-933-0999
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247404208000000X
TXP0983208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics