Individual
JOHN ANDREW SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
815 HIGHWAY 71 W, SUITE 1150 BLDG 1, BASTROP, TX 78602-3590
(512) 321-1098
(512) 303-0885
Mailing address
815 HIGHWAY 71 W, SUITE 1150 BLDG 1, BASTROP, TX 78602-3590
(512) 321-1098
(512) 303-0885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00581
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1024681
NATIONAL CERT NUM
TX
01
—
PA00581
STATE TX LIC NUM
TX
Enumeration date
04/09/2007
Last updated
04/27/2016
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