MEDICARE: DR. SARAH MARGARET VALLERY O.D.

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	152W00000X	Optometrist	5463T	TX

General Provider Information

NPI Number	:	1982775110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH MARGARET VALLERY O.D.

Provider Business Mailing Address
First Line	:	315 N MAPLE GLADE CIR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-1437
Country	:	US
Telephone Number	:	281-799-3295
Fax Number	:	281-362-9555

Provider Business Practice Location Address
First Line	:	3091 COLLEGE PARK DR
Second Line	:	SUITE 275
City	:	THE WOODLANDS
State	:	TX
Zip	:	77384-8023
Country	:	US
Telephone Number	:	936-271-4444
Fax Number	:	936-271-4580

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

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	04/03/2009

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