Healthcare Provider Details

I. General information

NPI: 1265095061
Provider Name (Legal Business Name): SARA LOUISE KOENIG LANGSTON APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 LANDA ST STE E
NEW BRAUNFELS TX
78130-6163
US

IV. Provider business mailing address

705 LANDA ST STE E
NEW BRAUNFELS TX
78130-6163
US

V. Phone/Fax

Practice location:
  • Phone: 210-360-1590
  • Fax: 210-855-9300
Mailing address:
  • Phone: 530-921-9592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP142266
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: