Provider Demographics
NPI:1295779452
Name:COLE, SARAH G (CRNA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:G
Last Name:COLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:DEPARTMENT 398
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:281-358-8114
Mailing Address - Fax:281-358-0609
Practice Address - Street 1:333 N TEXAS AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4966
Practice Address - Country:US
Practice Address - Phone:281-358-8114
Practice Address - Fax:281-358-0609
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR63612367500000X
TX748805367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202870601Medicaid
TX89926UOtherBCBS
TX202870601Medicaid