1780933374 NPI number — DR. ROBERT EDWIN SAWYER D.D.S.

Table of content: DR. ROBERT EDWIN SAWYER D.D.S. (NPI 1780933374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780933374 NPI number — DR. ROBERT EDWIN SAWYER D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAWYER
Provider First Name:
ROBERT
Provider Middle Name:
EDWIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780933374
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1117 RANCH RD 1431
Provider Second Line Business Mailing Address:
BOX 1606
Provider Business Mailing Address City Name:
KINGSLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78639
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-388-6021
Provider Business Mailing Address Fax Number:
325-388-9991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1117 RANCH RD 1431
Provider Second Line Business Practice Location Address:
POB 1606
Provider Business Practice Location Address City Name:
KINGSLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78639-4055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-388-6021
Provider Business Practice Location Address Fax Number:
325-388-9991
Provider Enumeration Date:
08/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  28332 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1235553900 . This is a "CENTRAL TEXAS FAMILY DENTISTRY PC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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