Physician Compare National (NPI:1336285840)

HEALTHCARE PROVIDER: SANDER JAY GOTHARD M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1336285840
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688762321
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071114000351
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOTHARD
	Individual professional last name
Provider First Name	SANDER
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	NORTH TEXAS VILLAGE HEALTH PARTNERS PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0244328987
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	23
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5425 W SPRING CREEK PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	200 VILLAGE HEALTH PARTNERS LLP
	Group Practice or individual's line 2 address
City	PLANO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750244237
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9725999600
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450651
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEDICAL CITY PLANO
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y