Healthcare Provider Details

I. General information

NPI: 1184531394
Provider Name (Legal Business Name): SARAH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1452 HUGHES RD STE 200
GRAPEVINE TX
76051-9221
US

IV. Provider business mailing address

1452 HUGHES RD STE 200
GRAPEVINE TX
76051-9221
US

V. Phone/Fax

Practice location:
  • Phone: 214-494-0320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number116693
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: