Provider Demographics
NPI:1609871938
Name:ESPARZA, SANDRA ANN (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 RED BUD LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3895
Mailing Address - Country:US
Mailing Address - Phone:512-310-9700
Mailing Address - Fax:512-310-9791
Practice Address - Street 1:1750 RED BUD LN
Practice Address - Street 2:STE 400
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3895
Practice Address - Country:US
Practice Address - Phone:512-310-9700
Practice Address - Fax:512-310-9791
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6876207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL6876OtherSTATE LICENSE
TXH97749Medicare UPIN
TX8B3044Medicare ID - Type Unspecified