Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | P9948 | TX |
NPI | 1396038998 |
---|---|
Provider Name | Damian Sacky |
First Address | Dallas, TX 75284-4658 |
Second Address | Marble Falls, TX 78654-8606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2011 |
Last Update Date | 09/10/2020 |