MEDICARE: JOHN DANIEL SANDOVAL RN

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	163W00000X	Registered Nurse	1161170	TX

General Provider Information

NPI Number	:	1699627430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN DANIEL SANDOVAL RN

Provider Business Mailing Address
First Line	:	1750 E LEAGUE CITY PKWY APT 637
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2894
Country	:	US
Telephone Number	:	512-304-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 BALL ST
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77551-8100
Country	:	US
Telephone Number	:	409-766-2315
Fax Number	:

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

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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