Provider Demographics
NPI:1801086376
Name:SADLER, SEAN ROBERT (PT)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:ROBERT
Last Name:SADLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RAINBOW DR # 10959
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77399-9301
Mailing Address - Country:US
Mailing Address - Phone:618-516-3160
Mailing Address - Fax:
Practice Address - Street 1:101 RAINBOW DR # 10959
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77399-9301
Practice Address - Country:US
Practice Address - Phone:618-516-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-30645225100000X
TX1291886225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist