Healthcare Provider Details

I. General information

NPI: 1477053411
Provider Name (Legal Business Name): SARA AMYS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2018
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E TAYLOR ST STE 308
SHERMAN TX
75090-2826
US

IV. Provider business mailing address

600 E TAYLOR ST STE 308
SHERMAN TX
75090-2826
US

V. Phone/Fax

Practice location:
  • Phone: 469-947-7463
  • Fax: 866-559-0952
Mailing address:
  • Phone: 699-477-4634
  • Fax: 866-559-0952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA14059
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number12625
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: