=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770151342
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SARAH TALBOTT, OD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2021
-----------------------------------------------------
Last Update Date | 10/07/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8701 NORTH TARRANT PARKWAY SUITE 400
-----------------------------------------------------
City | NORTH RICHLAND HILLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76182
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 682-348-3218
-----------------------------------------------------
Fax | 817-887-0874
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8701 N TARRANT PKWY STE 400
-----------------------------------------------------
City | NORTH RICHLAND HILLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76182-8510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 682-348-3218
-----------------------------------------------------
Fax | 817-887-0874
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | SARAH TALBOTT
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 682-348-3218
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------