Provider Demographics
NPI:1881858587
Name:FANKA, SARAH
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:
Last Name:FANKA
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 1:1815 EDWARDS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1825
Mailing Address - Country:US
Mailing Address - Phone:214-392-2542
Mailing Address - Fax:
Practice Address - Street 1:1815 EDWARDS CHURCH RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-1825
Practice Address - Country:US
Practice Address - Phone:214-575-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122286251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health