Provider Demographics
NPI:1538742861
Name:SAGE, RENE (RN)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:SAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:C.
Other - Middle Name:RENE
Other - Last Name:JUSTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:539 W COMMERCE ST # 4697
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1953
Mailing Address - Country:US
Mailing Address - Phone:469-726-8195
Mailing Address - Fax:
Practice Address - Street 1:13601 PRESTON RD STE 210W
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4986
Practice Address - Country:US
Practice Address - Phone:972-702-0300
Practice Address - Fax:903-532-1401
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2517852163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse