Provider Demographics
NPI:1750659082
Name:GARDNER, SARAH V (DO)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:V
Last Name:GARDNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 CITY POINT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8338
Mailing Address - Country:US
Mailing Address - Phone:817-284-8222
Mailing Address - Fax:817-595-5718
Practice Address - Street 1:4300 CITY POINT DR STE 201
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8338
Practice Address - Country:US
Practice Address - Phone:817-284-8222
Practice Address - Fax:817-595-5718
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10041370207R00000X
TXQ0048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine