Individual
ANGELA DAWN EARHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 KINGWOOD MEDICAL DRIVE, SUITE 215, KINGWOOD, TX 77339-4412
(832) 978-5611
(281) 205-0204
Mailing address
350 KINGWOOD MEDICAL DRIVE, SUITE 215, KINGWOOD, TX 77339-4412
(832) 978-5611
(281) 205-0204
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
M4767
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185571006
—
TX
01
—
8BZ693
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/19/2006
Last updated
02/14/2018
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