MEDICARE: SARA A ADAMS S.L.P.

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	102400	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992868822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA A ADAMS S.L.P.

Provider Business Mailing Address
First Line	:	5411 BASSWOOD BLVD
Second Line	:	221
City	:	FORT WORTH
State	:	TX
Zip	:	76137-4477
Country	:	US
Telephone Number	:	817-514-6333
Fax Number	:	817-514-6334

Provider Business Practice Location Address
First Line	:	5411 BASSWOOD BLVD
Second Line	:	221
City	:	FORT WORTH
State	:	TX
Zip	:	76137-4477
Country	:	US
Telephone Number	:	817-514-6333
Fax Number	:	817-514-6334

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	08/13/2009

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Directions to “ SARA A ADAMS S.L.P.” Practice Location

Language	Start Address	Practice Location

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