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Individual
KENNETH L. SANDERS
Active
Individual
KENNETH L. SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00304
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179883701
—
TX
01
—
8N4898
BLUE CROSS BLUE SHIELD
TX
01
—
P00705552
RAILROAD MEDICARE
TX
Enumeration date
07/27/2005
Last updated
07/08/2009
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