Individual
DR. GARY W SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C., F.A.S.A
Contact information
Practice address
4712 BOAT CLUB RD, FORT WORTH, TX 76135-2002
(817) 237-2930
(817) 237-4143
Mailing address
4712 BOAT CLUB RD, FORT WORTH, TX 76135-2002
(817) 237-2930
(817) 237-4143
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4758
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TXB129427
MEDICARE PTAN
TX
Enumeration date
02/08/2007
Last updated
11/14/2016
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