Provider Demographics
NPI:1912204116
Name:MOWERY, SARAH ELAINE (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELAINE
Last Name:MOWERY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELAINE
Other - Last Name:DARBONNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8000 N SAM HOUSTON PKWY E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-2900
Mailing Address - Country:US
Mailing Address - Phone:281-454-0101
Mailing Address - Fax:
Practice Address - Street 1:8000 N SAM HOUSTON PKWY E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-2900
Practice Address - Country:US
Practice Address - Phone:281-454-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07207363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA07207OtherTEXAS LICENSE #