MEDICARE: GEREMY L SANDERS MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1013292317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEREMY L SANDERS MD PA

Provider Business Mailing Address
First Line	:	9010 BRODIE LN STE D-100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5186
Country	:	US
Telephone Number	:	512-329-5705
Fax Number	:	512-329-5720

Provider Business Practice Location Address
First Line	:	9010 BRODIE LN STE D-100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5186
Country	:	US
Telephone Number	:	512-329-5705
Fax Number	:	512-329-5720

Authorized Official
Title or Position	:	OWNER OF PA
Name	:	GEREMY L SANDERS
Credential	:	MD
Telephone Number	:	512-329-5705

Provider Enumeration Date	:	10/18/2011
Last Update Date	:	01/22/2025

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