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NPI Code Detail

MEDICARE: MS. SABRINA ANSARI PA-S

MEDICARE: MS. SABRINA ANSARI PA-S
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1346894870
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SABRINA ANSARI PA-S
Provider Business Mailing Address
First Line : 2516 MERLIN DR
Second Line :
City : LEWISVILLE
State : TX
Zip : 75056-5702
Country : US
Telephone Number : 972-989-5440
Fax Number :
Provider Business Practice Location Address
First Line : 3600 N GARFIELD ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-6329
Country : US
Telephone Number : 432-620-1120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2019
Last Update Date : 08/01/2019

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