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General NPI Number Information
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NPI Number | 1780351908
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH SHAFFER PA
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Gender | Female
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 1201 FAIRMOUNT AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-4215
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Country | US
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Telephone | 817-335-5288
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Fax | 817-338-0927
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Provider Business Mailing Address
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Address Line | 601 OMEGA DR STE 208
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City | ARLINGTON
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State | TX
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Zip | 76014-2075
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Country | US
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Telephone | 817-465-5881
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Fax | 817-394-6294
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA14732
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA14732
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License Number State | TX
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