Provider Demographics
NPI:1942771118
Name:SARTOR, TONYA GRETCHEN
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:GRETCHEN
Last Name:SARTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MCKAIG CIR
Mailing Address - Street 2:
Mailing Address - City:GLADEWATER
Mailing Address - State:TX
Mailing Address - Zip Code:75647-2256
Mailing Address - Country:US
Mailing Address - Phone:903-738-9805
Mailing Address - Fax:
Practice Address - Street 1:9 MCKAIG CIR
Practice Address - Street 2:
Practice Address - City:GLADEWATER
Practice Address - State:TX
Practice Address - Zip Code:75647-2256
Practice Address - Country:US
Practice Address - Phone:903-738-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX196653164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse