Provider Demographics
NPI:1407870819
Name:SANDERS, ROBERT P (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12274 BANDERA RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4385
Mailing Address - Country:US
Mailing Address - Phone:210-780-7248
Mailing Address - Fax:210-780-7251
Practice Address - Street 1:12274 BANDERA RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4385
Practice Address - Country:US
Practice Address - Phone:210-780-7248
Practice Address - Fax:210-780-7251
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN11252080P0207X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2105215Medicaid
TX210521503OtherMEDICAID CSN
TX357757901Medicaid
TX8DE801OtherBCBS
TX210521503OtherMEDICAID CSN
TX357757901Medicaid
NCI38034Medicare UPIN
OK200088320AMedicare ID - Type UnspecifiedOK MEDICAID
MO209881200Medicaid
TN5440821Medicaid
TX210521502Medicaid
AL009938023Medicaid