Provider Demographics
NPI:1518981273
Name:NUCHE, SARAH (PH D)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NUCHE
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 LBJ FREEWAY
Mailing Address - Street 2:SUITE 254
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6462
Mailing Address - Country:US
Mailing Address - Phone:972-490-8833
Mailing Address - Fax:972-490-8834
Practice Address - Street 1:6350 LBJ FREEWAY
Practice Address - Street 2:SUITE 254
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6462
Practice Address - Country:US
Practice Address - Phone:972-490-8833
Practice Address - Fax:972-490-8834
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24785103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040830402Medicaid
TX00582EMedicare ID - Type Unspecified