Provider Demographics
NPI:1801856083
Name:SADLER, MICHAEL ALLAN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALLAN
Last Name:SADLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:MIKE
Other - Middle Name:A
Other - Last Name:SADLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:5860 WESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2602
Mailing Address - Country:US
Mailing Address - Phone:817-925-6407
Mailing Address - Fax:
Practice Address - Street 1:4200 S HULEN ST
Practice Address - Street 2:SUITE 425
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4907
Practice Address - Country:US
Practice Address - Phone:817-731-2875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234806367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered