MEDICARE: JENNIFER SANDERS

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	225X00000X	Occupational Therapist
2	225X00000X	Occupational Therapist	OT.0007899	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110319	OTHER	TX	LICENSE #

General Provider Information

NPI Number	:	1497860357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SANDERS

Provider Business Mailing Address
First Line	:	1400 N IH 35 STE 320
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1926
Country	:	US
Telephone Number	:	512-324-8320
Fax Number	:	512-324-8326

Provider Business Practice Location Address
First Line	:	1400 N IH 35 STE 320
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1926
Country	:	US
Telephone Number	:	512-324-8320
Fax Number	:	512-324-8326

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	10/09/2024

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Directions to “ JENNIFER SANDERS ” Practice Location

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