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NPI Code Detail

MEDICARE: EDWARD SANDERS JR.

MEDICARE:   EDWARD  SANDERS JR.
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
1246ZC0007XSurgical AssistantTX

General Provider Information

NPI Number : 1790339612
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD SANDERS JR.
Provider Business Mailing Address
First Line : 3435 WALNUT BEND LN APT 3207
Second Line :
City : HOUSTON
State : TX
Zip : 77042-4754
Country : US
Telephone Number : 832-396-3747
Fax Number :
Provider Business Practice Location Address
First Line : 4219 RICHMOND AVE STE 200
Second Line :
City : HOUSTON
State : TX
Zip : 77027-6838
Country : US
Telephone Number : 713-487-0001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2019
Last Update Date : 07/29/2019

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Directions to “ EDWARD SANDERS JR. ” Practice Location

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