Provider Demographics
NPI:1073500179
Name:PAYBERAH, SARAH N (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:N
Last Name:PAYBERAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 W PARKER RD.
Mailing Address - Street 2:SUITE 225
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8102
Mailing Address - Country:US
Mailing Address - Phone:972-981-7830
Mailing Address - Fax:972-981-7820
Practice Address - Street 1:6300 W PARKER RD.
Practice Address - Street 2:SUITE 225
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8102
Practice Address - Country:US
Practice Address - Phone:972-981-7830
Practice Address - Fax:972-981-7820
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9261207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG02325Medicare UPIN