MEDICARE: SARA DAHL

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	163W00000X	Registered Nurse	939767	TX

General Provider Information

NPI Number	:	1992503882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA DAHL

Provider Business Mailing Address
First Line	:	7701 MINHOTA DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76131-2726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7701 MINHOTA DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76131-2726
Country	:	US
Telephone Number	:	317-941-3524
Fax Number	:

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

Provider Enumeration Date	:	03/05/2025
Last Update Date	:	03/05/2025

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Directions to “ SARA DAHL ” Practice Location

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