Provider Demographics
NPI:1154490761
Name:SAHL, KATHERINE CLAIRE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:CLAIRE
Last Name:SAHL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 MERRIMAC CIRCLE
Mailing Address - Street 2:STE 200
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107
Mailing Address - Country:US
Mailing Address - Phone:817-870-4949
Mailing Address - Fax:817-338-2940
Practice Address - Street 1:1555 MERRIMAC CIRCLE
Practice Address - Street 2:STE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107
Practice Address - Country:US
Practice Address - Phone:817-870-4949
Practice Address - Fax:817-338-2940
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1100824222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1945210OtherFIRST HEALTH INS
TX87531TOtherBCBS
TX16185501Medicaid
TX87531TOtherBCBS