Provider Demographics
NPI:1013365691
Name:DWYRE, SARA BETH (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:DWYRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4521 SILVER HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5038
Mailing Address - Country:US
Mailing Address - Phone:512-529-4565
Mailing Address - Fax:
Practice Address - Street 1:4521 SILVER HOLLOW DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-5038
Practice Address - Country:US
Practice Address - Phone:512-529-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX807657163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse