Provider Demographics
NPI:1386870434
Name:MANKIN, SARAH ASHLEY (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ASHLEY
Last Name:MANKIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-2622
Mailing Address - Country:US
Mailing Address - Phone:806-765-2611
Mailing Address - Fax:806-687-5826
Practice Address - Street 1:3301 CLOVIS RD
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-5155
Practice Address - Country:US
Practice Address - Phone:806-763-5557
Practice Address - Fax:806-765-0754
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3647207Q00000X
NMA-1826-14207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530013101OtherFIRSTCARE
NM36288501Medicaid
TX305742402Medicaid
TX8FG361OtherBCBS
TX530013101OtherFIRSTCARE