Provider Demographics
NPI:1124593801
Name:BRACKENS, SARAH (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BRACKENS
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MACY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:7211 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4700
Mailing Address - Country:US
Mailing Address - Phone:469-303-3000
Mailing Address - Fax:469-303-4510
Practice Address - Street 1:7211 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4700
Practice Address - Country:US
Practice Address - Phone:469-303-3000
Practice Address - Fax:469-303-4510
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer