Provider Demographics
NPI:1750626024
Name:SIPES, SABRINA R (DPT)
Entity type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:R
Last Name:SIPES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:RIMOLDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1150 N WATTERS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5536
Mailing Address - Country:US
Mailing Address - Phone:469-247-6400
Mailing Address - Fax:469-912-1700
Practice Address - Street 1:1150 N WATTERS RD STE 105
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5536
Practice Address - Country:US
Practice Address - Phone:469-247-6400
Practice Address - Fax:469-912-1700
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23539172V00000X
TX1286066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX591405ZGGXOtherMEDICARE PTAN