Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K9167 | TX |
Y | 208600000X | Surgeon | K9167 | TX |
NPI | 1023083839 |
---|---|
Provider Name | Dr. Tammy Lee Sartor |
First Address | Wichita Falls, TX 76301-5620 |
Second Address | Wichita Falls, TX 76301-5620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 02/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
156969101 | (05) | TX |
G58932 | (02) | TX |