Provider Demographics
NPI:1730454646
Name:BERINGER, SANDRA D (CST CSFA)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:D
Last Name:BERINGER
Suffix:
Gender:F
Credentials:CST CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-5604
Mailing Address - Country:US
Mailing Address - Phone:214-227-2457
Mailing Address - Fax:972-463-7257
Practice Address - Street 1:1901 MILLER RD
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-5604
Practice Address - Country:US
Practice Address - Phone:214-227-2457
Practice Address - Fax:972-463-7257
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108635164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse