Individual
DR. MARISA SANDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
134 MENGER SPGS, SUITE 1120, BOERNE, TX 78006-7218
(210) 593-5700
(210) 593-5992
Mailing address
134 MENGER SPGS, SUITE 1120, BOERNE, TX 78006-7218
(210) 593-5700
(210) 593-5992
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
M0556
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1745390-01
—
TX
01
—
1745390-02
CSHCN
TX
05
—
1745390-03
—
TX
01
—
8S1845
BLUE SHIELD
TX
01
—
P00269397
RR/MEDICARE
TX
Enumeration date
04/03/2006
Last updated
07/11/2013
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