Provider Demographics
NPI:1902114481
Name:SAWYERS, TOMMY SCOTT (CRNA)
Entity Type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:SCOTT
Last Name:SAWYERS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-648-7833
Mailing Address - Fax:214-648-6799
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-648-7833
Practice Address - Fax:214-648-6799
Is Sole Proprietor?:No
Enumeration Date:2010-09-19
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX762499163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8219UBOtherBLUE CROSS BLUE SHIELD
TXP00936595OtherRAILROAD MEDICARE
TX8219UBOtherBLUE CROSS BLUE SHIELD