Provider Demographics
NPI:1477871143
Name:HERINGER, SARAH KRISTYNE (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KRISTYNE
Last Name:HERINGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17051 NORTH DALLAS PARKWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001
Mailing Address - Country:US
Mailing Address - Phone:972-733-3090
Mailing Address - Fax:972-733-4565
Practice Address - Street 1:17051 NORTH DALLAS PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001
Practice Address - Country:US
Practice Address - Phone:972-733-3090
Practice Address - Fax:972-733-4565
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
TXPA06769363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical