Provider Demographics
NPI:1629283171
Name:SANDS, LAWRENCE (DO, MPH)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:SANDS
Suffix:
Gender:M
Credentials:DO, MPH
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 3902
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89127-3902
Mailing Address - Country:US
Mailing Address - Phone:702-759-1201
Mailing Address - Fax:702-383-6341
Practice Address - Street 1:625 SHADOW LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4118
Practice Address - Country:US
Practice Address - Phone:702-759-1201
Practice Address - Fax:702-383-6341
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1210251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare