Provider Demographics
NPI:1295056059
Name:STEPHENSON, SARA LOUISE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LOUISE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:103 S PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5905
Mailing Address - Country:US
Mailing Address - Phone:325-643-8080
Mailing Address - Fax:325-643-8188
Practice Address - Street 1:103 S PARK DR STE B
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5905
Practice Address - Country:US
Practice Address - Phone:325-643-8080
Practice Address - Fax:325-643-8188
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06537363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical