Healthcare Provider Details

I. General information

NPI: 1457573222
Provider Name (Legal Business Name): SARAH KENT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 US HIGHWAY 380 SUITE 101
CROSSROADS TX
76227-2464
US

IV. Provider business mailing address

321 HWY. 380 SUITE 101
CROSS ROADS TX
76227
US

V. Phone/Fax

Practice location:
  • Phone: 940-365-9389
  • Fax: 940-365-9128
Mailing address:
  • Phone: 940-365-9389
  • Fax: 940-365-9128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.121428
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP4971
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: