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NPI Code Detail

MEDICARE: DR. DERIK SANDERS, D.C. LLC

MEDICARE: DR. DERIK SANDERS, D.C. LLC
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
1111N00000XChiropractor10290TX

General Provider Information

NPI Number : 1932640653
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. DERIK SANDERS, D.C. LLC
Provider Business Mailing Address
First Line : 2511 KEEPSAKE DR
Second Line :
City : AUSTIN
State : TX
Zip : 78745-6369
Country : US
Telephone Number : 512-494-1880
Fax Number :
Provider Business Practice Location Address
First Line : 300 BEARDSLEY LN BLDG E
Second Line : SUITE 104
City : AUSTIN
State : TX
Zip : 78746-4954
Country : US
Telephone Number : 512-494-1880
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. DERIK PAUL SANDERS
Credential : D.C.
Telephone Number : 512-934-1002
Provider Enumeration Date : 03/14/2017
Last Update Date : 03/22/2017

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