Provider Demographics
NPI:1144668500
Name:EMBRY, SANDRA SALADINO (LM)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SALADINO
Last Name:EMBRY
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15752 COUNTY ROAD 4059
Mailing Address - Street 2:
Mailing Address - City:KEMP
Mailing Address - State:TX
Mailing Address - Zip Code:75143
Mailing Address - Country:US
Mailing Address - Phone:903-498-6346
Mailing Address - Fax:
Practice Address - Street 1:542 E HIGHWAY 64 LOT 533
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103-3311
Practice Address - Country:US
Practice Address - Phone:469-632-4840
Practice Address - Fax:972-584-9811
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02006176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife