Provider Demographics
NPI:1275198988
Name:KENNEDY, SARAH ANNE (DO)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 MERIT DR STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-3117
Mailing Address - Country:US
Mailing Address - Phone:469-840-4888
Mailing Address - Fax:469-840-4886
Practice Address - Street 1:12201 MERIT DR STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3117
Practice Address - Country:US
Practice Address - Phone:469-840-4888
Practice Address - Fax:469-840-4886
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU4238207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology