Provider Demographics
NPI:1396207031
Name:SARRETT, ROWDY DWIGHT (PA-C)
Entity Type:Individual
Prefix:
First Name:ROWDY
Middle Name:DWIGHT
Last Name:SARRETT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 BROADWAY BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-3400
Mailing Address - Country:US
Mailing Address - Phone:972-240-1789
Mailing Address - Fax:214-575-9929
Practice Address - Street 1:4402 BROADWAY BLVD STE 1
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-3400
Practice Address - Country:US
Practice Address - Phone:972-240-1789
Practice Address - Fax:972-240-5525
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12726207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine