Individual
JUSTIN K SANDEFUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4900 MUELLER BLVD, AUSTIN, TX 78723-3079
(512) 324-0515
Mailing address
4624 PAGE ST, AUSTIN, TX 78723-5484
(512) 748-5404
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
AP139467
TX
363LA2100X
Acute Care Nurse Practitioner
AP139467
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP139467
TX
Other
Enumeration date
10/28/2018
Last updated
03/25/2025
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