Individual ProviderSara Al DogomStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3601 4th St, Lubbock, TX 79430-0002(806) 743-2669(434) 987-0169PECOS EnrollmentBased on the most recent information from CMS, provider Sara Al Dogom is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1003480054Provider TypeIndividualFull NameAl Dogom, SaraCredentialMDGenderFemaleSole ProprietorNoEnumeration Date5/14/2021Last Updated7/2/2024Contact InformationPractice LocationPractice Address3601 4th St, Lubbock, TX 79430-0002Phone(806) 743-2669FaxUnlisted FaxMailing LocationMailing Address1215 Lee St, Mailbox 800501, Charlottesville, VA 22908-0816Phone(434) 987-0169FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense0116038830VirginiaCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseBP10075621Texas