Provider Demographics
NPI:1942460464
Name:WOOD, SARA DOUTHETT (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:DOUTHETT
Last Name:WOOD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10718 OPAL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4682
Mailing Address - Country:US
Mailing Address - Phone:281-256-0679
Mailing Address - Fax:
Practice Address - Street 1:9055 KATY FWY
Practice Address - Street 2:SUITE 306
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1624
Practice Address - Country:US
Practice Address - Phone:713-464-9999
Practice Address - Fax:713-490-5424
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX631754363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L7339Medicaid