Provider Demographics
NPI:1033669346
Name:SADR, GOLNAZ (CNS)
Entity Type:Individual
Prefix:MS
First Name:GOLNAZ
Middle Name:
Last Name:SADR
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9715 BURNET RD
Mailing Address - Street 2:BLDG. 7, STE. 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5215
Mailing Address - Country:US
Mailing Address - Phone:512-505-5500
Mailing Address - Fax:512-334-2702
Practice Address - Street 1:2600 E MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-1449
Practice Address - Country:US
Practice Address - Phone:512-505-5500
Practice Address - Fax:512-334-2702
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131518364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology