MEDICARE: WILLIAM PATRICK SAGE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	D6160	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	214881	OTHER	IL	GROUP MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4365757	OTHER	TX	AETNA
3	84K502	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1437140118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM PATRICK SAGE M.D.

Provider Business Mailing Address
First Line	:	117 MEDICAL DRIVE
Second Line	:	SUITE 1
City	:	VICTORIA
State	:	TX
Zip	:	77904-3102
Country	:	US
Telephone Number	:	361-573-4331
Fax Number	:	361-573-5096

Provider Business Practice Location Address
First Line	:	117 MEDICAL DRIVE
Second Line	:	SUITE 1
City	:	VICTORIA
State	:	TX
Zip	:	77904-3102
Country	:	US
Telephone Number	:	361-573-4331
Fax Number	:	361-573-5096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	08/18/2016

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Directions to “ WILLIAM PATRICK SAGE M.D.” Practice Location

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