Provider Demographics
NPI:1437119187
Name:SANDERS, DERIK PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:DERIK
Middle Name:PAUL
Last Name:SANDERS
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 1:4201 BEE CAVE RD
Mailing Address - Street 2:SUITE C-212
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6465
Mailing Address - Country:US
Mailing Address - Phone:512-347-8035
Mailing Address - Fax:512-347-8034
Practice Address - Street 1:4201 BEE CAVE RD
Practice Address - Street 2:SUITE C-212
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6465
Practice Address - Country:US
Practice Address - Phone:512-347-8035
Practice Address - Fax:512-347-8034
Is Sole Proprietor?:No
Enumeration Date:2006-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor