Provider Demographics
NPI:1215312608
Name:ANGER, SARA (PTA, BS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ANGER
Suffix:
Gender:F
Credentials:PTA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6217 W MASTERS DR
Mailing Address - Street 2:APT 1535
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-6875
Mailing Address - Country:US
Mailing Address - Phone:267-226-2165
Mailing Address - Fax:
Practice Address - Street 1:2350 AIRPORT FWY STE 455
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-4011
Practice Address - Country:US
Practice Address - Phone:817-508-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2109873225200000X
PATE010168225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant