Provider Demographics
NPI:1881885077
Name:MUCOWSKI, SARA J (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:J
Last Name:MUCOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2840 LEGACY DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:214-297-0020
Mailing Address - Fax:214-297-0025
Practice Address - Street 1:3600 GASTON AVE STE 1001
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1810
Practice Address - Country:US
Practice Address - Phone:214-423-4032
Practice Address - Fax:214-423-4031
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0029070207V00000X
CAA116178207V00000X
TXP8951207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4658084376OtherMYUTMB 4658084376