Provider Demographics
NPI:1154927440
Name:LYLE, SARAH ANN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:LYLE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 N MESA ST BLDG A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2333
Mailing Address - Country:US
Mailing Address - Phone:915-351-1183
Mailing Address - Fax:
Practice Address - Street 1:3100 N MESA ST BLDG A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2333
Practice Address - Country:US
Practice Address - Phone:915-351-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist