Basic Information
Provider Information
NPI: 1780926394
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SASSER
FirstName: SIERRA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6213 SKYLINE DR
Address2: STE. 200
City: HOUSTON
State: TX
PostalCode: 770577036
CountryCode: US
TelephoneNumber: 7138804400
FaxNumber: 7138698637
Practice Location
Address1: 8868 RESEARCH BLVD
Address2: STE. 601
City: AUSTIN
State: TX
PostalCode: 787586497
CountryCode: US
TelephoneNumber: 5126153000
FaxNumber: 5126153001
Other Information
ProviderEnumerationDate: 03/21/2013
LastUpdateDate: 03/21/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1219706TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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