Healthcare Provider Details

I. General information

NPI: 1942706353
Provider Name (Legal Business Name): SARAH LEVIC CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MUSIL

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 MEDICAL DR
SAN ANTONIO TX
78229-4402
US

IV. Provider business mailing address

903 W MARTIN ST
SAN ANTONIO TX
78207-0903
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-4000
  • Fax:
Mailing address:
  • Phone: 210-358-0572
  • Fax: 210-358-5940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number70026
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1116100
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: