Individual
STEFANIE N SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1545 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6422
(817) 442-9300
(817) 796-0763
Mailing address
PO BOX 502, ROANOKE, TX 76262-0502
(214) 227-2457
(214) 699-4418
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA04819
TX
Other
Enumeration date
06/09/2005
Last updated
09/11/2018
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