Provider Demographics
NPI:1578517116
Name:SADLER CLINIC ASSOC
Entity Type:Organization
Organization Name:SADLER CLINIC ASSOC
Other - Org Name:SADLER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:CPCS
Authorized Official - Phone:936-521-7344
Mailing Address - Street 1:9201 PINECROFT DR
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9201 PINECROFT DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3222
Practice Address - Country:US
Practice Address - Phone:281-297-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094010801Medicaid
TX094010801Medicaid
TX00J21AMedicare PIN
GAC17195Medicare PIN