Provider Demographics
NPI:1679833917
Name:LALAN, SAURABH (MD)
Entity type:Individual
Prefix:DR
First Name:SAURABH
Middle Name:
Last Name:LALAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-8514
Mailing Address - Country:US
Mailing Address - Phone:504-261-3159
Mailing Address - Fax:
Practice Address - Street 1:3201 W GORE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6350
Practice Address - Country:US
Practice Address - Phone:580-585-5448
Practice Address - Fax:580-354-5963
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK379802084N0400X
AZ741622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology