Provider Demographics
NPI:1992223705
Name:PRATER, SARAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:PRATER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11400 EDGEMERE BLVD APT 2105
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-2419
Mailing Address - Country:US
Mailing Address - Phone:903-316-4663
Mailing Address - Fax:
Practice Address - Street 1:10765 KENWORTHY ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-1717
Practice Address - Country:US
Practice Address - Phone:915-821-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist