Healthcare Provider Details

I. General information

NPI: 1023634987
Provider Name (Legal Business Name): SARAH LOUISE SUERTE LAXA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH LOUISE LOCSIN SUERTE PHARMD

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 ST JOSEPH PKWY STE 1300
HOUSTON TX
77002-8298
US

IV. Provider business mailing address

1315 ST JOSEPH PKWY STE 1300
HOUSTON TX
77002-8298
US

V. Phone/Fax

Practice location:
  • Phone: 409-383-8076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59069
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: