Provider Demographics
NPI:1023822616
Name:MCCAMBRIDGE, SADIE G
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:G
Last Name:MCCAMBRIDGE
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 1:2817 COUNTY ROAD 101
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:TX
Mailing Address - Zip Code:79545-2107
Mailing Address - Country:US
Mailing Address - Phone:817-304-0718
Mailing Address - Fax:
Practice Address - Street 1:2817 COUNTY ROAD 101
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:TX
Practice Address - Zip Code:79545-2107
Practice Address - Country:US
Practice Address - Phone:817-304-0718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer