Provider Demographics
NPI:1609017706
Name:SANDERS, DOROTHY BROWN (PT)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:BROWN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1371
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76095-1371
Mailing Address - Country:US
Mailing Address - Phone:817-399-0100
Mailing Address - Fax:
Practice Address - Street 1:1600 CENTRAL DR
Practice Address - Street 2:SUITE #156
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6000
Practice Address - Country:US
Practice Address - Phone:214-403-3813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009090208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1009090OtherPHYSICAL THERAPY AND OCCUPATIONAL THERAPY