Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stefanie N Sanderson, PA-C

Individual provider Surgical Physician Assistant · NPI 1750385456

Stefanie N Sanderson, PA-C is a Physician Assistant in Southlake, Texas. Qualified in 2001, 25 years ago. Accepts Medicare assignment. Licensed in Texas.

Years since qualifying
25
Licensed in
TX
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1545 E Southlake Blvd Ste 100
Southlake, TX 76092-6422
Phone: (817) 442-9300
Fax: (817) 796-0763
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA04819 (TX)

Record details

NPI number1750385456
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 9, 2005
Last updated in NPPESSeptember 11, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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