Provider Demographics
NPI:1275225021
Name:CIRILDO, SARAH PRISCILLA
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:PRISCILLA
Last Name:CIRILDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 BRYANT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77053-3374
Mailing Address - Country:US
Mailing Address - Phone:830-422-1407
Mailing Address - Fax:
Practice Address - Street 1:4730 BRYANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77053-3374
Practice Address - Country:US
Practice Address - Phone:830-422-1407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX278174183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician