Healthcare Provider Details

I. General information

NPI: 1629663638
Provider Name (Legal Business Name): SARA HOUSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 WALKING PATH PLACE
HILLSBOROUGH NC
27278
US

IV. Provider business mailing address

181 WALKING PATH PLACE
HILLSBOROUGH NC
27278
US

V. Phone/Fax

Practice location:
  • Phone: 919-699-7040
  • Fax:
Mailing address:
  • Phone: 919-699-7040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP015914
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: