Provider Demographics
NPI:1437398211
Name:SANGER MEDICAL CLINIC, P.A.
Entity Type:Organization
Organization Name:SANGER MEDICAL CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:DINGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-825-3333
Mailing Address - Street 1:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266-0892
Mailing Address - Country:US
Mailing Address - Phone:940-458-3400
Mailing Address - Fax:940-458-3431
Practice Address - Street 1:1602 W CHAPMAN DR
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-9054
Practice Address - Country:US
Practice Address - Phone:940-458-3400
Practice Address - Fax:940-458-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A5425Medicare PIN