MEDICARE: SARAH JANE SUGAREK

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	235Z00000X	Speech-Language Pathologist	118912	TX

General Provider Information

NPI Number	:	1801555636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH JANE SUGAREK

Provider Business Mailing Address
First Line	:	1062 SUGAREK RANCH LANE
Second Line	:
City	:	BEEVILLE
State	:	TX
Zip	:	78102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 W HUNTINGTON ST
Second Line	:
City	:	BEEVILLE
State	:	TX
Zip	:	78102-2599
Country	:	US
Telephone Number	:	254-368-9320
Fax Number	:

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

Provider Enumeration Date	:	12/09/2021
Last Update Date	:	12/09/2021

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Directions to “ SARAH JANE SUGAREK ” Practice Location

Language	Start Address	Practice Location

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