Provider Demographics
NPI:1568482578
Name:SAWYER, CALEB RANDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:RANDALL
Last Name:SAWYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:925 SANTA FE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5866
Mailing Address - Country:US
Mailing Address - Phone:682-300-2020
Mailing Address - Fax:817-789-6290
Practice Address - Street 1:925 SANTA FE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5866
Practice Address - Country:US
Practice Address - Phone:682-300-2020
Practice Address - Fax:817-789-6290
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006031059207W00000X
TXM3727207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO6150650001OtherDME
MO6150650001OtherDME