MEDICARE: SARAH DALE MEDINA

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	231H00000X	Audiologist	81962	TX

General Provider Information

NPI Number	:	1679410823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DALE MEDINA

Provider Business Mailing Address
First Line	:	4711 SPICEWOOD SPRINGS RD UNIT 139
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8475
Country	:	US
Telephone Number	:	512-653-9247
Fax Number	:

Provider Business Practice Location Address
First Line	:	13210 W US HIGHWAY 290
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-9324
Country	:	US
Telephone Number	:	737-260-0100
Fax Number	:

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

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ SARAH DALE MEDINA ” Practice Location

Language	Start Address	Practice Location

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