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General NPI Number Information
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NPI Number | 1982256251
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Entity Type | Individual
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Provider Name | SARAH A KOSTUSIAK
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Gender | Female
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 101 TAYLOR ST
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City | HUTTO
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State | TX
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Zip | 78634-4510
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Country | US
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Telephone | 512-826-2854
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Fax |
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Provider Business Mailing Address
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Address Line | 2153 COUNTY ROAD 101
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City | HUTTO
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State | TX
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Zip | 78634-3225
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Country | US
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Telephone | 512-826-2854
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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