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General NPI Number Information
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NPI Number | 1104735901
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Entity Type | Individual
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Provider Name | WILLIAM SAGE
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Gender | Male
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Dates
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Enumeration Date | 09/05/2026
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Last Update Date | 09/05/2026
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Provider Practice Location Address
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Address Line | 1515 COMMERCE ST
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City | FORT WORTH
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State | TX
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Zip | 76102-6509
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Country | US
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Telephone | 817-212-3935
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 COMMERCE ST
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City | FORT WORTH
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State | TX
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Zip | 76102-6509
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number | N0426
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License Number State | TX
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