Provider Demographics
NPI:1114225323
Name:CAUDLE, SARAH MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:CAUDLE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2280 HIGHLAND VILLAGE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7146
Mailing Address - Country:US
Mailing Address - Phone:972-317-6000
Mailing Address - Fax:972-317-8503
Practice Address - Street 1:2280 HIGHLAND VILLAGE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7146
Practice Address - Country:US
Practice Address - Phone:972-317-6000
Practice Address - Fax:972-317-8503
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA07172363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant