Provider Demographics
NPI:1649029869
Name:STEVENS, SARAH CAMILLE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CAMILLE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18611 EASTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-1303
Mailing Address - Country:US
Mailing Address - Phone:281-488-0179
Mailing Address - Fax:
Practice Address - Street 1:18611 EASTFIELD DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1303
Practice Address - Country:US
Practice Address - Phone:281-488-0179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX295456183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician