Provider Demographics
NPI:1558031922
Name:SAWYERR, MIATTA RUTH (NP)
Entity Type:Individual
Prefix:
First Name:MIATTA
Middle Name:RUTH
Last Name:SAWYERR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 W LAMPASAS ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4500
Mailing Address - Country:US
Mailing Address - Phone:972-875-4700
Mailing Address - Fax:
Practice Address - Street 1:802 W LAMPASAS ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4500
Practice Address - Country:US
Practice Address - Phone:972-875-4700
Practice Address - Fax:972-878-4527
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF08210772207Q00000X
TX1059486363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine