MEDICARE: DR. SARAH FRAY AU.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	231H00000X	Audiologist	81170	TX

General Provider Information

NPI Number	:	1720647993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH FRAY AU.D.

Provider Business Mailing Address
First Line	:	2201 SE LOOP 820
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76119-5863
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 SE LOOP 820
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76119-5863
Country	:	US
Telephone Number	:	817-730-0179
Fax Number	:

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

Provider Enumeration Date	:	06/11/2019
Last Update Date	:	06/11/2019

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