MEDICARE: DR. THOMAS SAKO DDS

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	122300000X	Dentist	14569	TX

General Provider Information

NPI Number	:	1831165315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS SAKO DDS

Provider Business Mailing Address
First Line	:	19050 STONE OAK PARKWAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258
Country	:	US
Telephone Number	:	210-499-0388
Fax Number	:	210-499-1018

Provider Business Practice Location Address
First Line	:	19050 STONE OAK PKWY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3225
Country	:	US
Telephone Number	:	210-499-0388
Fax Number	:	210-499-1018

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	07/08/2007

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