Provider Demographics
NPI:1295000214
Name:SARRO, JARED DOUGLAS (IDC)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:DOUGLAS
Last Name:SARRO
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8218 SAM SNEAD ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2946
Mailing Address - Country:US
Mailing Address - Phone:210-875-8332
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09589
Practice Address - Country:US
Practice Address - Phone:01153-997-2125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman