=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659650935
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH FRY PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2011
-----------------------------------------------------
Last Update Date | 01/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1710 KELLER PKWY # 9965
-----------------------------------------------------
City | KELLER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76248-3749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-229-9038
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1710 KELLER PKWY # 9965 #9965
-----------------------------------------------------
City | KELLER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76248-3749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-229-9038
-----------------------------------------------------
Fax | 512-229-9038
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | AP120645
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------