MEDICARE: SARAH NUGENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	2076787	TX

General Provider Information

NPI Number	:	1669864278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH NUGENT

Provider Business Mailing Address
First Line	:	1902 FM 3036
Second Line	:
City	:	ROCKPORT
State	:	TX
Zip	:	78382-9691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1902 FM 3036
Second Line	:
City	:	ROCKPORT
State	:	TX
Zip	:	78382-9691
Country	:	US
Telephone Number	:	979-733-6241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2015
Last Update Date	:	02/19/2015

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Directions to “ SARAH NUGENT ” Practice Location

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