Healthcare Provider Details

I. General information

NPI: 1497586457
Provider Name (Legal Business Name): SARAH VESTAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 FM 407 STE 160
HIGHLAND VILLAGE TX
75077-3055
US

IV. Provider business mailing address

909 BANNOCK ST APT 915
DENVER CO
80204-4163
US

V. Phone/Fax

Practice location:
  • Phone: 972-236-7060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0109057
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1213714
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: