Healthcare Provider Details

I. General information

NPI: 1124177423
Provider Name (Legal Business Name): SANFORD T. WARD, D.O., PROFESSIONAL ASSOCIATIION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3719 22ND ST
LUBBOCK TX
79410-1329
US

IV. Provider business mailing address

3719 22ND ST
LUBBOCK TX
79410-1329
US

V. Phone/Fax

Practice location:
  • Phone: 806-795-4336
  • Fax: 806-785-4309
Mailing address:
  • Phone: 806-795-4336
  • Fax: 806-785-4309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberE2383
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberE2383
License Number StateTX

VIII. Authorized Official

Name: SANFORD T. WARD
Title or Position: PRESIDENT
Credential: D.O.
Phone: 806-795-4336