Healthcare Provider Details

I. General information

NPI: 1356722193
Provider Name (Legal Business Name): SARAH MAREDIA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 07/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9825 S MASON RD STE 120
RICHMOND TX
77406
US

IV. Provider business mailing address

9825 S MASON RD STE 120
RICHMOND TX
77406-5882
US

V. Phone/Fax

Practice location:
  • Phone: 832-595-6500
  • Fax:
Mailing address:
  • Phone: 832-595-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30831
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: