1316199664 NPI number — STEPHANIE LOUISE SANDERS MS, PT

Table of content: STEPHANIE LOUISE SANDERS MS, PT (NPI 1316199664)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316199664 NPI number — STEPHANIE LOUISE SANDERS MS, PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANDERS
Provider First Name:
STEPHANIE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HINTZEL
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316199664
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1615
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GIDDINGS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78942
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-542-7300
Provider Business Mailing Address Fax Number:
979-542-7373

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
283 E RAILROAD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GIDDINGS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-542-7300
Provider Business Practice Location Address Fax Number:
979-542-7373
Provider Enumeration Date:
10/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1173110 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com