Provider Demographics
NPI:1669792321
Name:RECKELHOFF, SARA E (FNP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:E
Last Name:RECKELHOFF
Suffix:
Gender:F
Credentials:FNP
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 111849
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77293-0849
Mailing Address - Country:US
Mailing Address - Phone:713-695-9947
Mailing Address - Fax:713-699-6218
Practice Address - Street 1:5990 AIRLINE DR
Practice Address - Street 2:#160
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-4233
Practice Address - Country:US
Practice Address - Phone:713-695-9947
Practice Address - Fax:713-699-6218
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX775302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily