Individual
DR. KENNETH A. SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
K2997
TX
2085R0202X
Diagnostic Radiology Physician
Primary
K2997
TX
2085U0001X
Diagnostic Ultrasound Physician
K2997
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446304-03
—
TX
05
—
1446304-04
—
TX
05
—
1446304-05
—
TX
01
—
8L26728
MEDICARE - STRIC
TX
01
—
K2997
TEXAS MEDICAL LICENSE
TX
01
—
P00829953
RAILROAD MEDICARE
TX
01
—
P00845684
RAILROAD MEDICARE
TX
Enumeration date
12/22/2005
Last updated
04/09/2016
Update your record
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