Provider Demographics
NPI:1639571391
Name:JIAN, SARAH (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:JIAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5939 HARRY HINES BLVD POB II
Mailing Address - Street 2:SUITE 334
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-3646
Mailing Address - Country:US
Mailing Address - Phone:214-645-0599
Mailing Address - Fax:214-645-3297
Practice Address - Street 1:5939 HARRY HINES BLVD POB 2 STE 334
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-3646
Practice Address - Country:US
Practice Address - Phone:214-645-0599
Practice Address - Fax:214-645-3297
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant