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General NPI Number Information
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NPI Number | 1801275177
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Entity Type | Individual
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Provider Name | SANDRA CORDOVA PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 150 W SHADOWBEND AVE SUITE 100
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-3968
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Country | US
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Telephone | 281-576-9343
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Fax | 866-462-7454
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Provider Business Mailing Address
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Address Line | 150 W SHADOWBEND AVE STE 200
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-3970
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Country | US
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Telephone | 281-576-9343
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Fax | 866-462-7454
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 36849
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License Number State | TX
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