Provider Demographics
NPI:1396976585
Name:SUTTLE, SARA E (DPM)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:SUTTLE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 HIGHWAY 121
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5013
Mailing Address - Country:US
Mailing Address - Phone:817-540-4477
Mailing Address - Fax:817-540-5633
Practice Address - Street 1:2425 HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5013
Practice Address - Country:US
Practice Address - Phone:817-540-4477
Practice Address - Fax:817-540-5633
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2013213E00000X, 213ES0103X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160531302Medicaid
TX363105301Medicaid