Provider Demographics
NPI:1316307655
Name:KOWAL, SARAH ANGELINA (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANGELINA
Last Name:KOWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANGELINA
Other - Last Name:SLIEF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3041 CHURCHILL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-5906
Mailing Address - Country:US
Mailing Address - Phone:972-691-1240
Mailing Address - Fax:972-691-2073
Practice Address - Street 1:3041 CHURCHILL DR STE 300
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-5906
Practice Address - Country:US
Practice Address - Phone:972-691-1240
Practice Address - Fax:972-691-2073
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU4242208000000X
NE30259208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty