Healthcare Provider Details

I. General information

NPI: 1811424807
Provider Name (Legal Business Name): SARAH KAY LANGSTON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH KAY HENRY

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 12/29/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 8TH STREET
WICHITA FALLS TX
76301
US

IV. Provider business mailing address

PO BOX 9261
WICHITA FALLS TX
76308-9261
US

V. Phone/Fax

Practice location:
  • Phone: 940-764-5400
  • Fax: 940-764-5454
Mailing address:
  • Phone: 940-764-7230
  • Fax: 940-764-7255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberS2385
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10061108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: