Provider Demographics
NPI:1013052281
Name:SAWYER, KIMBER LANGSTON (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KIMBER
Middle Name:LANGSTON
Last Name:SAWYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KIMBER
Other - Middle Name:LEE
Other - Last Name:LANGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:17500 HIGHWAY 3 STE B
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4153
Mailing Address - Country:US
Mailing Address - Phone:281-338-2098
Mailing Address - Fax:281-557-4369
Practice Address - Street 1:17500 HIGHWAY 3 STE B
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4153
Practice Address - Country:US
Practice Address - Phone:281-338-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05000363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical