Provider Demographics
NPI:1578164836
Name:ANDERSON, SARAH (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 E RENNER RD APT 1723
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2851
Mailing Address - Country:US
Mailing Address - Phone:708-420-5099
Mailing Address - Fax:
Practice Address - Street 1:9990 DALLAS PKWY STE 125
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4137
Practice Address - Country:US
Practice Address - Phone:817-337-6604
Practice Address - Fax:817-337-6866
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA13761363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant