Provider Demographics
NPI:1306346820
Name:MATULIK, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MATULIK
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 1:1020 LINDSEY CIR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-4424
Mailing Address - Country:US
Mailing Address - Phone:254-217-2923
Mailing Address - Fax:
Practice Address - Street 1:1020 LINDSEY CIR
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-4424
Practice Address - Country:US
Practice Address - Phone:254-217-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201124164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse