Healthcare Provider Details

I. General information

NPI: 1093711699
Provider Name (Legal Business Name): RHONDA P SANDERS PHYSICAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 01/27/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 GRAHAM DR STE B
TOMBALL TX
77375-6451
US

IV. Provider business mailing address

929 GRAHAM DR STE B
TOMBALL TX
77375-6451
US

V. Phone/Fax

Practice location:
  • Phone: 281-351-5548
  • Fax: 281-351-5020
Mailing address:
  • Phone: 281-351-5548
  • Fax: 281-351-5020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00622
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: