Provider Demographics
NPI:1376344895
Name:LARSEN, SARAH BETH (LM, CPM)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:LARSEN
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-2325
Mailing Address - Country:US
Mailing Address - Phone:469-995-5478
Mailing Address - Fax:469-599-7180
Practice Address - Street 1:2422 PATRICK ST
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-2325
Practice Address - Country:US
Practice Address - Phone:469-995-5478
Practice Address - Fax:469-599-7180
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99596176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife