MEDICARE: DR. SCOTT J SANDS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	E2840	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235137621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT J SANDS M.D.

Provider Business Mailing Address
First Line	:	3601 4TH STREET
Second Line	:	STOP 7217
City	:	LUBBOCK
State	:	TX
Zip	:	79430
Country	:	US
Telephone Number	:	806-743-2020
Fax Number	:	806-743-2471

Provider Business Practice Location Address
First Line	:	928 SOUTH BOLTON STREET
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766
Country	:	US
Telephone Number	:	903-586-7900
Fax Number	:	903-586-4373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	11/04/2019

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Directions to “ DR. SCOTT J SANDS M.D.” Practice Location

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