Provider Demographics
NPI:1346282225
Name:SANDERS, STEVEN B (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:SANDERS
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 1:2120 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2225
Mailing Address - Country:US
Mailing Address - Phone:972-438-4636
Mailing Address - Fax:
Practice Address - Street 1:2120 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2225
Practice Address - Country:US
Practice Address - Phone:972-438-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0240207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88Y421OtherBLUE CROSS
TX200030464OtherRAILROAD MEDICARE
TX047172401Medicaid
TX88Y421Medicare ID - Type Unspecified
TXG02734Medicare UPIN