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General NPI Number Information
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NPI Number | 1982400156
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Entity Type | Individual
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Provider Name | LAUREN RENEE SANDIDGE DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 7840 FM 1960 RD E STE AND409
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City | HUMBLE
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State | TX
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Zip | 77346-2259
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Country | US
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Telephone | 281-812-6665
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Fax | 281-812-6869
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Provider Business Mailing Address
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Address Line | 133 VENTI CV
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City | GEORGETOWN
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State | TX
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Zip | 78628-2173
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Country | US
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Telephone | 704-359-7661
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1406176
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License Number State | TX
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