Provider Demographics
NPI:1376307132
Name:SANDFORD, REAGAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:
Last Name:SANDFORD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2187 W SOUTH LOOP STE A
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-3921
Mailing Address - Country:US
Mailing Address - Phone:254-918-0724
Mailing Address - Fax:254-918-0883
Practice Address - Street 1:2187 W SOUTH LOOP STE A
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-3921
Practice Address - Country:US
Practice Address - Phone:254-918-0724
Practice Address - Fax:254-918-0883
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1388809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist