MEDICARE: SARA WESTGATE M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	K6738	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0034EJ	OTHER		BCBS

General Provider Information

NPI Number	:	1336147941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA WESTGATE M.D., PH.D.

Provider Business Mailing Address
First Line	:	5900 SOUTHWEST PKWY
Second Line	:	SUITE 401
City	:	AUSTIN
State	:	TX
Zip	:	78735-6202
Country	:	US
Telephone Number	:	512-458-6656
Fax Number	:	512-458-1035

Provider Business Practice Location Address
First Line	:	5900 SOUTHWEST PKWY
Second Line	:	SUITE 401
City	:	AUSTIN
State	:	TX
Zip	:	78735-6202
Country	:	US
Telephone Number	:	512-458-6656
Fax Number	:	512-458-1035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	03/26/2010

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