MEDICARE: MS. SARA MATANI 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	T9577	TX

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

General Provider Information

NPI Number	:	1629481957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARA MATANI M.D.

Provider Business Mailing Address
First Line	:	6844 HARRIS PKWY STE 300
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76132-4281
Country	:	US
Telephone Number	:	817-263-0007
Fax Number	:	817-263-1118

Provider Business Practice Location Address
First Line	:	6844 HARRIS PARKWAY
Second Line	:
City	:	FT. WORTH
State	:	TX
Zip	:	76132-7613
Country	:	US
Telephone Number	:	817-263-0007
Fax Number	:	817-263-1118

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

Provider Enumeration Date	:	06/04/2014
Last Update Date	:	05/08/2025

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