Provider Demographics
NPI:1326201450
Name:JOHLE, SARAH C (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:C
Last Name:JOHLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-0846
Mailing Address - Country:US
Mailing Address - Phone:512-846-1004
Mailing Address - Fax:512-846-1006
Practice Address - Street 1:202 HWY 79
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634
Practice Address - Country:US
Practice Address - Phone:512-846-1004
Practice Address - Fax:512-846-1006
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7269TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist