Provider Demographics
NPI:1770695397
Name:AUSTIN, SARA (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W 38TH ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1121
Mailing Address - Country:US
Mailing Address - Phone:512-637-5854
Mailing Address - Fax:512-637-5969
Practice Address - Street 1:711 W 38TH ST
Practice Address - Street 2:SUITE F1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1121
Practice Address - Country:US
Practice Address - Phone:512-637-5854
Practice Address - Fax:512-637-5969
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ04302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0082HAOtherBCBS
TX00844QMedicare ID - Type Unspecified
TX0082HAOtherBCBS