Provider Demographics
NPI:1225023013
Name:SANFORD, BARBARA T (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:T
Last Name:SANFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10513 NUNN JONES RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-9459
Mailing Address - Country:US
Mailing Address - Phone:979-776-0093
Mailing Address - Fax:979-776-0093
Practice Address - Street 1:4343 CARTER CREEK PKWY
Practice Address - Street 2:SUITE 119
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-4491
Practice Address - Country:US
Practice Address - Phone:979-691-8500
Practice Address - Fax:979-691-5755
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4688103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J33PMedicare ID - Type UnspecifiedMEDICARE