Provider Demographics
NPI:1740268895
Name:SANFORD, DONALD KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:KEITH
Last Name:SANFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3338 OAKWELL CT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3086
Mailing Address - Country:US
Mailing Address - Phone:210-930-2015
Mailing Address - Fax:210-822-3690
Practice Address - Street 1:3338 OAKWELL CT
Practice Address - Street 2:SUITE 212
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3086
Practice Address - Country:US
Practice Address - Phone:210-930-2015
Practice Address - Fax:210-822-3690
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-07
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7095207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF48864Medicare UPIN