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NPI Code Detail

MEDICARE: JEORGIA SANDERS

MEDICARE: JEORGIA 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
12255A2300XAthletic TrainerAT9159TX

General Provider Information

NPI Number : 1841183274
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEORGIA SANDERS
Provider Business Mailing Address
First Line : 3100 CLEBURNE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-4598
Country : US
Telephone Number : 224-522-4119
Fax Number :
Provider Business Practice Location Address
First Line : 3100 CLEBURNE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-4598
Country : US
Telephone Number : 224-522-4119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2025
Last Update Date : 06/03/2025

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Directions to “ JEORGIA SANDERS ” Practice Location

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