Healthcare Provider Details

I. General information

NPI: 1922264217
Provider Name (Legal Business Name): SARAH BAKER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MAXWELL NONE

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US

IV. Provider business mailing address

2480 LLEWELLYN AVE
FORT GEORGE G MEADE MD
20755-5800
US

V. Phone/Fax

Practice location:
  • Phone: 102-221-7373
  • Fax:
Mailing address:
  • Phone: 301-677-8796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberPTL-10017
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL-10017
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: