Provider Demographics
NPI:1821647660
Name:SANDS, ALICIA DAVIDA (MED, MA)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:DAVIDA
Last Name:SANDS
Suffix:
Gender:F
Credentials:MED, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 VERHALEN AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-2466
Mailing Address - Country:US
Mailing Address - Phone:713-560-4445
Mailing Address - Fax:
Practice Address - Street 1:4002 VERHALEN AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-2466
Practice Address - Country:US
Practice Address - Phone:713-560-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty