Provider Demographics
NPI:1124364831
Name:SAGLIME, JOHN T JR (PSY D)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:SAGLIME
Suffix:JR
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 AVENUE F N
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3167
Mailing Address - Country:US
Mailing Address - Phone:979-245-2008
Mailing Address - Fax:
Practice Address - Street 1:1400 PRESTON RD STE 260
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5183
Practice Address - Country:US
Practice Address - Phone:214-396-3960
Practice Address - Fax:214-396-3962
Is Sole Proprietor?:No
Enumeration Date:2012-12-27
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36650103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX351769003Medicaid