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General NPI Number Information
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NPI Number | 1649038266
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Entity Type | Individual
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Provider Name | OLIVIA SULA LAEHN PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 6701 FANNIN ST # D.060033
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City | HOUSTON
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State | TX
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Zip | 77030-2608
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Country | US
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Telephone | 832-822-1508
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WATERWAY AVE APT 2136
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City | THE WOODLANDS
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State | TX
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Zip | 77380-3463
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Country | US
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Telephone | 254-760-3610
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA17706
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License Number State | TX
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