Provider Demographics
NPI:1487739132
Name:SABO, TONIA M (MD)
Entity type:Individual
Prefix:DR
First Name:TONIA
Middle Name:M
Last Name:SABO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:M
Other - Last Name:SABO-GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-456-2768
Mailing Address - Fax:214-456-6869
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-456-2768
Practice Address - Fax:214-456-6869
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 132700000X, 222Q00000X
CO348822084N0400X
TXK98942084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO52759342Medicaid
COST12.06.10Medicare PIN