Healthcare Provider Details
I. General information
NPI: 1629481957
Provider Name (Legal Business Name): SARA MATANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/04/2014
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6844 HARRIS PARKWAY
FT. WORTH TX
76132-7613
US
IV. Provider business mailing address
6844 HARRIS PKWY STE 300
FT WORTH TX
76132-4281
US
V. Phone/Fax
- Phone: 817-263-0007
- Fax: 817-263-1118
- Phone: 817-263-0007
- Fax: 817-263-1118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | T9577 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: