Provider Demographics
NPI:1235364191
Name:SANBORN, MCLEAN RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:MCLEAN
Middle Name:RICHARD
Last Name:SANBORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N INTERSTATE 35 STE 302
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-5151
Mailing Address - Country:US
Mailing Address - Phone:940-565-9118
Mailing Address - Fax:940-383-2512
Practice Address - Street 1:2900 N INTERSTATE 35 STE 302
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-5151
Practice Address - Country:US
Practice Address - Phone:940-565-9118
Practice Address - Fax:940-383-2512
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX415253YKP5Medicare PIN
TXPENDINGOtherBCBS
TXPENDINGMedicare PIN