Provider Demographics
NPI:1558661298
Name:DK SANDERS, PSYD & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DK SANDERS, PSYD & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:281-333-5250
Mailing Address - Street 1:18333 EGRET BAY BLVD STE 145
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3371
Mailing Address - Country:US
Mailing Address - Phone:281-333-5250
Mailing Address - Fax:281-333-5260
Practice Address - Street 1:213 W SOUTHMORE AVE STE 303
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1026
Practice Address - Country:US
Practice Address - Phone:281-333-5250
Practice Address - Fax:281-333-5260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157110102Medicaid
611153Medicare PIN