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Organization
SUNRISE ADVANCED PEDIATRICS PLLC
Active
Organization
SUNRISE ADVANCED PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PEARSON SANDERS MD (AUTHORIZED REP/OWNER)
(210) 780-7248
Entity
Organization
Contact information
Practice address
12274 BANDERA RD, SUITE 104, HELOTES, TX 78023-4385
(210) 780-7248
(210) 780-7251
Mailing address
12274 BANDERA RD, SUITE 104, HELOTES, TX 78023-4385
(210) 780-7248
(210) 780-7251
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
TX
2080P0207X
Pediatric Hematology & Oncology Physician
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
357756101
—
TX
Enumeration date
03/07/2016
Last updated
07/05/2016
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