Provider Demographics
NPI:1710971759
Name:NORTH, SARAH LOWERY (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LOWERY
Last Name:NORTH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:LOWERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:135 BUNTON CREEK RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5756
Mailing Address - Country:US
Mailing Address - Phone:512-268-4700
Mailing Address - Fax:512-268-4703
Practice Address - Street 1:135 BUNTON CREEK RD
Practice Address - Street 2:SUITE 303
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5756
Practice Address - Country:US
Practice Address - Phone:512-268-4700
Practice Address - Fax:512-268-4703
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1157278225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8543250OtherAETNA
TX8T5230OtherBCBS
1041335OtherBLUELINK
1041335OtherBLUELINK
TX8F4964Medicare PIN
TXB137071Medicare PIN
TXTXB133688Medicare PIN
00636YMedicare PIN