Provider Demographics
NPI:1558691956
Name:SARA WESTGATE MD PA
Entity Type:Organization
Organization Name:SARA WESTGATE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTGATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:512-458-6656
Mailing Address - Street 1:5900 SOUTHWEST PKWY
Mailing Address - Street 2:BUILDING 4, SUITE 401
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6202
Mailing Address - Country:US
Mailing Address - Phone:512-458-6656
Mailing Address - Fax:
Practice Address - Street 1:5900 SOUTHWEST PKWY
Practice Address - Street 2:BUILDING 4, SUITE 401
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6202
Practice Address - Country:US
Practice Address - Phone:512-458-6656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK67382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG77892Medicare UPIN