Provider Demographics
NPI:1831735505
Name:LADDUSAW, SADIE CHRISTINE (C-AA)
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:CHRISTINE
Last Name:LADDUSAW
Suffix:
Gender:F
Credentials:C-AA
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:
Other - Last Name:CATLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 E 79TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1924
Mailing Address - Country:US
Mailing Address - Phone:308-482-0044
Mailing Address - Fax:
Practice Address - Street 1:12221 N MOPAC EXPY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2401
Practice Address - Country:US
Practice Address - Phone:512-901-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32697667367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant