Provider Demographics
NPI:1093738791
Name:SABRA, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:SABRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2028 E BEN WHITE BLVD STE 240-3187
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6966
Mailing Address - Country:US
Mailing Address - Phone:512-887-3187
Mailing Address - Fax:512-887-3197
Practice Address - Street 1:3107 OAK CREEK DR STE 120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727
Practice Address - Country:US
Practice Address - Phone:512-887-3187
Practice Address - Fax:512-887-3197
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7151208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160721001Medicaid
TX8A9555Medicare PIN
TX160721001Medicaid