Provider Demographics
NPI:1538986609
Name:MCDUGLE, SARA KATHERINE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:KATHERINE
Last Name:MCDUGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20202 KENTUCKY TRCE
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-8795
Mailing Address - Country:US
Mailing Address - Phone:832-326-0307
Mailing Address - Fax:
Practice Address - Street 1:20202 KENTUCKY TRCE
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-8795
Practice Address - Country:US
Practice Address - Phone:832-326-0307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218544224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant