Provider Demographics
NPI:1902415698
Name:BURGE, SARA (AUD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BURGE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MEDICAL FL 2
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5392
Mailing Address - Country:US
Mailing Address - Phone:830-264-2044
Mailing Address - Fax:
Practice Address - Street 1:105 MEDICAL FL 2
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5392
Practice Address - Country:US
Practice Address - Phone:302-402-8268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81277231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist