Provider Demographics
NPI:1326382946
Name:SANFORD, AUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:SANFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3936 AMBERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4426
Mailing Address - Country:US
Mailing Address - Phone:972-740-8187
Mailing Address - Fax:
Practice Address - Street 1:3939 BELT LINE RD FL 7
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4323
Practice Address - Country:US
Practice Address - Phone:972-740-8187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor