Provider Demographics
NPI:1023097490
Name:SAKLER, THOMAS ALLEN (OD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALLEN
Last Name:SAKLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111MARVIN D LOVE FRWY
Mailing Address - Street 2:STE 101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201
Mailing Address - Country:US
Mailing Address - Phone:972-298-5379
Mailing Address - Fax:972-283-5863
Practice Address - Street 1:7111MARVAN D LOVE FRWY
Practice Address - Street 2:STE 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201
Practice Address - Country:US
Practice Address - Phone:972-298-5379
Practice Address - Fax:972-283-5863
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2447TG152W00000X
GA812152W00000X
KY859152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T15704Medicare UPIN
TX00E01LMedicare ID - Type Unspecified