Provider Demographics
NPI:1972797801
Name:YOUNG, SARA ELIZABETH (LPT)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ELIZABETH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 E HALL ST STE A
Mailing Address - Street 2:
Mailing Address - City:BANGS
Mailing Address - State:TX
Mailing Address - Zip Code:76823-5401
Mailing Address - Country:US
Mailing Address - Phone:325-752-6819
Mailing Address - Fax:325-752-6906
Practice Address - Street 1:807 E HALL ST STE A
Practice Address - Street 2:
Practice Address - City:BANGS
Practice Address - State:TX
Practice Address - Zip Code:76823-5401
Practice Address - Country:US
Practice Address - Phone:325-752-6819
Practice Address - Fax:325-752-6906
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F7789Medicare PIN