Provider Demographics
NPI:1174531883
Name:SANDERS, DONNA (DC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17049
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77552-7049
Mailing Address - Country:US
Mailing Address - Phone:409-740-7977
Mailing Address - Fax:409-740-6730
Practice Address - Street 1:2115 61ST ST
Practice Address - Street 2:#101
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-7406
Practice Address - Country:US
Practice Address - Phone:409-740-7977
Practice Address - Fax:409-740-6730
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603446Medicare ID - Type Unspecified
U19828/603446Medicare UPIN