Individual
CLIFFORD SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
36065 SANTA FE AVE, FORT CAVAZOS, TX 76544
(210) 539-9582
Mailing address
36065 SANTA FE AVE, FORT CAVAZOS, TX 76544-5060
(254) 553-4653
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1138818
—
Other
Enumeration date
12/21/2016
Last updated
08/09/2023
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