Provider Demographics
NPI:1104367317
Name:JAMAL, SARAH (DPT)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:
Last Name:JAMAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8177 MIDTOWN BLVD
Mailing Address - Street 2:APT. 5302
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:580-695-3082
Mailing Address - Fax:
Practice Address - Street 1:8177 MIDTOWN BLVD
Practice Address - Street 2:APT. 5302
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4573
Practice Address - Country:US
Practice Address - Phone:580-695-3082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1281589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist