Provider Demographics
NPI:1851872162
Name:SAWE, ELIZABETH BETHUEL (LVN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:BETHUEL
Last Name:SAWE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14350 DALLAS PKWY APT 1090
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8308
Mailing Address - Country:US
Mailing Address - Phone:214-713-8083
Mailing Address - Fax:
Practice Address - Street 1:14350 DALLAS PKWY APT 1090
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-8308
Practice Address - Country:US
Practice Address - Phone:214-713-8083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224924164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX08406927OtherTEXAS DRIVER'S LICENSE