MEDICARE: SHANNON 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	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1700729134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON SANDERS

Provider Business Mailing Address
First Line	:	23202 SNOWY RIDGE DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-2105
Country	:	US
Telephone Number	:	346-740-3212
Fax Number	:

Provider Business Practice Location Address
First Line	:	23202 SNOWY RIDGE DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-2105
Country	:	US
Telephone Number	:	346-740-3212
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ SHANNON SANDERS ” Practice Location

Language	Start Address	Practice Location

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