Provider Demographics
NPI:1447688858
Name:ROBERTSON, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 FIELDER NORTH PLZ
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2309
Mailing Address - Country:US
Mailing Address - Phone:817-461-4257
Mailing Address - Fax:817-461-4865
Practice Address - Street 1:520 FIELDER NORTH PLZ
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2309
Practice Address - Country:US
Practice Address - Phone:817-461-4257
Practice Address - Fax:817-461-4865
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1236289225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist