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General NPI Number Information
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NPI Number | 1386975134
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Entity Type | Organization
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Legal Business Name | SARAH CHERIYAN MD PA
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 206 GASLIGHT BLVD
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City | LUFKIN
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State | TX
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Zip | 75904-3166
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Country | US
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Telephone | 936-639-1110
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Fax | 936-639-2466
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Provider Business Mailing Address
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Address Line | 206 GASLIGHT BLVD
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City | LUFKIN
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State | TX
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Zip | 75904-3166
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Country | US
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Telephone | 936-639-1110
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Fax | 936-639-2466
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARAH CHERIYAN
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Credential | MD
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Telephone | 936-639-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | K0680
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License Number State | TX
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