MEDICARE: DR. SARAH OUSHY DMD

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	1223G0001X	General Practice Dentistry	37210	TX

General Provider Information

NPI Number	:	1649849563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH OUSHY DMD

Provider Business Mailing Address
First Line	:	8537 DUKE TER APT 9204
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-1726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 N TARRANT PKWY STE 101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7307
Country	:	US
Telephone Number	:	817-534-6455
Fax Number	:

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

Provider Enumeration Date	:	06/24/2021
Last Update Date	:	06/24/2021

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