Provider Demographics
NPI:1083114052
Name:LANGE, SARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:LANGE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:MERRIKHIHAGHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 E CORPORATE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-6687
Mailing Address - Country:US
Mailing Address - Phone:972-299-8990
Mailing Address - Fax:
Practice Address - Street 1:2005 FORT WORTH HWY STE 100
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4780
Practice Address - Country:US
Practice Address - Phone:817-953-6604
Practice Address - Fax:817-668-7637
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD61847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist