Basic Information
| Provider Information | |||||||||
| NPI: | 1790163780 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARUCCI | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | LITTLE | ||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | LITTLE | ||||||||
| OtherFirstName: | SARAH | ||||||||
| OtherMiddleName: | HART | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8300 FLOYD CURL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104509000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8300 FLOYD CURL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104509000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2015 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 35334 | AL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RG0100X | T4554 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207R00000X | T4554 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.