Healthcare Provider Details

I. General information

NPI: 1649393562
Provider Name (Legal Business Name): SANDRA L HOTZ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2007
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 ECHO LN STE 335
HOUSTON TX
77024
US

IV. Provider business mailing address

11 HUDSON CIR
HOUSTON TX
77024-7254
US

V. Phone/Fax

Practice location:
  • Phone: 713-751-8899
  • Fax: 832-871-5555
Mailing address:
  • Phone: 713-465-5805
  • Fax: 713-652-2717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3-1590
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3-1590
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: