MEDICARE: CHARIS CHRISTIANA SARRADET PA-C

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	363A00000X	Physician Assistant	PA12862	TX

General Provider Information

NPI Number	:	1841852530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARIS CHRISTIANA SARRADET PA-C

Provider Business Mailing Address
First Line	:	2624 KINGSRIDGE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-5836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3060 COMMUNICATIONS PKWY STE 204
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8459
Country	:	US
Telephone Number	:	972-312-8429
Fax Number	:

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

Provider Enumeration Date	:	07/02/2019
Last Update Date	:	04/14/2021

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Directions to “ CHARIS CHRISTIANA SARRADET PA-C” Practice Location

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