Individual
DR. SCOTT G SAGRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-2640
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
2012021382
MO
2086S0127X
Trauma Surgery Physician
200000607
NC
2086S0127X
Trauma Surgery Physician
2012021382
MO
2086S0127X
Trauma Surgery Physician
Primary
R4136
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126GT
BCBS NC
NC
05
—
89126GT
—
NC
01
—
990015449
RAILROAD MEDICARE
NC
Enumeration date
10/10/2005
Last updated
07/21/2022
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