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General NPI Number Information
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NPI Number | 1336269018
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Entity Type | Individual
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Provider Name | SARAH YORK BOOSTROM MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 1705 OHIO DR STE 100
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City | PLANO
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State | TX
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Zip | 75093-5256
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Country | US
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Telephone | 972-612-0430
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Fax | 844-585-6193
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Provider Business Mailing Address
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Address Line | 1705 OHIO DR STE 100
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City | PLANO
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State | TX
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Zip | 75093-5256
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Country | US
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Telephone | 972-612-0430
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Fax | 844-585-6193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | P6341
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | P6341
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License Number State | TX
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