Individual
DR. SARA RUTH FAVORITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
5625 BROADWAY AVE, SAN ANTONIO, TX 78209
(210) 264-5122
(210) 822-7321
Mailing address
5625 BROADWAY AVE, SAN ANTONIO, TX 78209
(210) 264-5122
(210) 822-7321
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
32427
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1690638-01
—
TX
Enumeration date
07/18/2006
Last updated
11/20/2015
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