Provider Demographics
NPI:1922863844
Name:BELL, SARA PAULINE (LMT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:PAULINE
Last Name:BELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-1713
Mailing Address - Country:US
Mailing Address - Phone:361-765-7278
Mailing Address - Fax:
Practice Address - Street 1:5525 S STAPLES ST STE A5
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5361
Practice Address - Country:US
Practice Address - Phone:361-765-7278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT036923225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist