Provider Demographics
NPI:1811930787
Name:DAVIS, SARA J (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:J
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6873 GREENWICH LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2845
Mailing Address - Country:US
Mailing Address - Phone:214-604-8666
Mailing Address - Fax:
Practice Address - Street 1:6873 GREENWICH LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2845
Practice Address - Country:US
Practice Address - Phone:214-604-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04715363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant