Provider Demographics
NPI:1205549185
Name:FOOTE, SARAH (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FOOTE
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 1:8300 N LAMAR BLVD STE 200A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5976
Mailing Address - Country:US
Mailing Address - Phone:512-387-8208
Mailing Address - Fax:512-782-9316
Practice Address - Street 1:5315 GREENVILLE AVE STE 120A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-2995
Practice Address - Country:US
Practice Address - Phone:469-809-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1100623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
XXXXXOtherI DON'T KNOW WHAT THIS IS