MEDICARE: DR. EMILY KATHERINE SANDLIN 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	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	S0980	TX
2	2084P0800X	Psychiatry Physician	S0980	TX

General Provider Information

NPI Number	:	1730567116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY KATHERINE SANDLIN M.D.

Provider Business Mailing Address
First Line	:	6750 HILLCREST PLAZA DRIVE
Second Line	:	SUITE #310
City	:	DALLAS
State	:	TX
Zip	:	75230
Country	:	US
Telephone Number	:	469-708-2488
Fax Number	:	833-964-0144

Provider Business Practice Location Address
First Line	:	6750 HILLCREST PLAZA DR STE 310
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1432
Country	:	US
Telephone Number	:	469-708-2488
Fax Number	:	833-964-0144

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

Provider Enumeration Date	:	05/18/2015
Last Update Date	:	03/21/2024

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