Provider Demographics
NPI:1649823360
Name:PARSON, SAGE (AGCNS-BC)
Entity type:Individual
Prefix:
First Name:SAGE
Middle Name:
Last Name:PARSON
Suffix:
Gender:F
Credentials:AGCNS-BC
Other - Prefix:
Other - First Name:SAGE
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6100 NEW IBERIA CT APT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-6930
Mailing Address - Country:US
Mailing Address - Phone:903-915-0416
Mailing Address - Fax:
Practice Address - Street 1:3901A SPICEWOOD SPRINGS RD STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8728
Practice Address - Country:US
Practice Address - Phone:903-915-0416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142304364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health