Healthcare Provider Details

I. General information

NPI: 1699863845
Provider Name (Legal Business Name): RONALD DAVID SANDLER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 FAIRMONT PKWY STE 130
PASADENA TX
77505-4022
US

IV. Provider business mailing address

6021 FAIRMONT PKWY STE 130
PASADENA TX
77505-4022
US

V. Phone/Fax

Practice location:
  • Phone: 281-991-0600
  • Fax: 281-991-0638
Mailing address:
  • Phone: 281-991-0600
  • Fax: 281-991-0638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number0461
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: