Provider Demographics
NPI:1730909805
Name:ELSHARKAWY, SARA (IBCLC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ELSHARKAWY
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 TEAL TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4098
Mailing Address - Country:US
Mailing Address - Phone:469-478-1670
Mailing Address - Fax:
Practice Address - Street 1:1401 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7763
Practice Address - Country:US
Practice Address - Phone:512-528-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty