Healthcare Provider Details

I. General information

NPI: 1558691956
Provider Name (Legal Business Name): SARA WESTGATE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 SOUTHWEST PKWY BUILDING 4, SUITE 401
AUSTIN TX
78735-6202
US

IV. Provider business mailing address

5900 SOUTHWEST PKWY BUILDING 4, SUITE 401
AUSTIN TX
78735-6202
US

V. Phone/Fax

Practice location:
  • Phone: 512-458-6656
  • Fax:
Mailing address:
  • Phone: 512-458-6656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberK6738
License Number StateTX

VIII. Authorized Official

Name: DR. SARA WESTGATE
Title or Position: PRESIDENT
Credential: M.D., PH.D.
Phone: 512-458-6656