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NPI Code Detail

MEDICARE: DR. TIMOTHY VAUGHN SANDELL M.D.

MEDICARE: DR. TIMOTHY VAUGHN SANDELL M.D.
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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician34408CO

General Provider Information

NPI Number : 1679522254
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY VAUGHN SANDELL M.D.
Provider Business Mailing Address
First Line : 7951 SHOAL CREEK BLVD STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78757-7582
Country : US
Telephone Number : 512-584-8404
Fax Number : 737-377-0442
Provider Business Practice Location Address
First Line : 6025 DELMONICO DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-2251
Country : US
Telephone Number : 719-634-7246
Fax Number : 855-592-2816
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 11/20/2025

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