Provider Demographics
NPI:1477873859
Name:AMIN, SANOBER (MD, PHD)
Entity Type:Individual
Prefix:
First Name:SANOBER
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 E BYRON NELSON BLVD UNIT 1638
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-6269
Mailing Address - Country:US
Mailing Address - Phone:214-337-6362
Mailing Address - Fax:214-337-6329
Practice Address - Street 1:1600 W COLLEGE ST STE LL40
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:214-337-6362
Practice Address - Fax:214-337-6329
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6389207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology