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NPI Code Detail

MEDICARE: DR. SARAH S. AVERY M.D.

MEDICARE:  DR. SARAH S. AVERY  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
12085R0202XDiagnostic Radiology PhysicianK7983TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2102555303OTHERTXCSHCN1
3300127105OTHERRRMCARE2
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5102555304OTHERTXCSHCN2
6300112315OTHERRRMCARE1

General Provider Information

NPI Number : 1770585937
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH S. AVERY M.D.
Provider Business Mailing Address
First Line : 12554 RIATA VISTA CIR
Second Line :
City : AUSTIN
State : TX
Zip : 78727-6431
Country : US
Telephone Number : 512-795-5100
Fax Number : 512-795-5122
Provider Business Practice Location Address
First Line : 12554 RIATA VISTA CIR
Second Line :
City : AUSTIN
State : TX
Zip : 78727-6431
Country : US
Telephone Number : 512-795-5100
Fax Number : 512-795-5122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 01/12/2015

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Directions to “ DR. SARAH S. AVERY M.D.” Practice Location

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