Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 246050 | TX |
NPI | 1073541439 |
---|---|
Provider Name | Mrs. Karen Florence Sacks |
First Address | Dallas, TX 75243-7543 |
Second Address | Dallas, TX 75231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S75660 | (02) | TX |