Individual
ETHAN LANCE SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-6393
Mailing address
123 KENT ST APT 3, BROOKLINE, MA 02445-6978
(303) 520-8967
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R8267
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2012
Last updated
12/10/2020
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