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NPI Code Detail

MEDICARE: DEVIN ACE SANDERS ATP

MEDICARE: DEVIN ACE SANDERS ATP
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
1247200000XOther Technician97221TX

General Provider Information

NPI Number : 1366286221
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVIN ACE SANDERS ATP
Provider Business Mailing Address
First Line : 1221 PROFIT DR
Second Line :
City : DALLAS
State : TX
Zip : 75247-3919
Country : US
Telephone Number : 832-374-6397
Fax Number :
Provider Business Practice Location Address
First Line : 8916 OAK GROVE RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76140-5124
Country : US
Telephone Number : 832-374-6397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2024
Last Update Date : 06/24/2024

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Directions to “ DEVIN ACE SANDERS ATP” Practice Location

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