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Individual
MARK ALLEN SANDERS
Active
Individual
MARK ALLEN SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.131054
IL
207Q00000X
Family Medicine Physician
Primary
K9653
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036.131054
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
K9653
TX
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
036.131054
IL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
K8653
TX
209800000X
Legal Medicine (M.D./D.O.) Physician
036.131054
IL
209800000X
Legal Medicine (M.D./D.O.) Physician
K9653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080186304
RAILROAD MEDICARE PIN
TX
05
—
151887001
—
TX
05
—
151887003
—
TX
05
—
151887004
—
TX
01
—
8B2215
BCBS
TX
Enumeration date
03/31/2006
Last updated
06/24/2015
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