Basic Information
| Provider Information | |||||||||
| NPI: | 1912915927 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ACOSTA | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSPA, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5080 SPECTRUM DR STE 1200W | ||||||||
| Address2: | |||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750014624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727207820 | ||||||||
| FaxNumber: | 2147754502 | ||||||||
| Practice Location | |||||||||
| Address1: | 3007 TOWN CENTER DR STE 100-110 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283063662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103541281 | ||||||||
| FaxNumber: | 9107792025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 06/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 0010-00367 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA07226 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.