Provider Demographics
NPI:1023771896
Name:BALCH, SARA ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:BALCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 BANKS ST.
Mailing Address - Street 2:UNIT 2
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098
Mailing Address - Country:US
Mailing Address - Phone:601-500-2009
Mailing Address - Fax:337-233-7978
Practice Address - Street 1:2011 E. BROADWAY
Practice Address - Street 2:STE. 130
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581
Practice Address - Country:US
Practice Address - Phone:281-997-8509
Practice Address - Fax:888-449-0039
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09710R225100000X
TX1358784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA09710ROtherPT LICENSE NUMBER