Provider Demographics
NPI:1649431156
Name:SARA DOWNEY, DC
Entity type:Organization
Organization Name:SARA DOWNEY, DC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-642-1919
Mailing Address - Street 1:PO BOX 530838
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75053-0838
Mailing Address - Country:US
Mailing Address - Phone:972-642-1919
Mailing Address - Fax:972-642-1617
Practice Address - Street 1:638 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5529
Practice Address - Country:US
Practice Address - Phone:972-642-1919
Practice Address - Fax:972-642-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX607162OtherBCBS
TX655606OtherACN GROUP
TX00155896Medicaid
TX14208OtherASH
1055848OtherASH PROMIS ID
TX170604601Medicaid
TX608955OtherBCBS GROUP
1055848OtherASH PROMIS ID