Individual
DR. SANDRA LEE GOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
4333 N JOSEY LN, STE 206, CARROLLTON, TX 75010-4629
(972) 939-1757
(972) 939-1682
Mailing address
4333 N JOSEY LN, STE 206, CARROLLTON, TX 75010-4629
(972) 939-1757
(972) 939-1682
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0940
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0940
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045404301
—
TX
05
—
080689501
—
TX
01
—
752774903
TAX INDENTIFICATION NUMBE
TX
01
—
86981S
BCBS PROVIDER NUMBER
TX
Enumeration date
12/23/2005
Last updated
04/08/2013
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