Reema Sacks, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA07711 Issued in TX

Practice address

601 Zena Rucker Rd
Southlake
Southlake, TX 76092-6386

Phone

(817) 488-6334

NPI assigned

Mar 19, 2012

Reactivated

Oct 26, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1871868232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 W 15TH ST",
            "address_2": "STE B",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757700",
            "telephone_number": "972-612-6900",
            "fax_number": "972-612-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ZENA RUCKER RD",
            "address_2": "SOUTHLAKE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926386",
            "telephone_number": "817-488-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS",
        "first_name": "REEMA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2017-08-09",
        "deactivation_date": "2012-06-13",
        "reactivation_date": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA07711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wallace R Ryne, O.D.
• Lilit Saakova, OD
• Noor Saba
• Karthik Sabapathy, D.O.
• Tonya Paschall Sabus, O.T.R.
• Raphael Augustus Sadiwa, PT, DPT
• Andrew Sadousky, MS, FNP-C
• Timothy Saeed, D.O.
• Valorie Anne Saenz
• Maureen Saffarian, OT

• Medical Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.