Provider Demographics
NPI:1972513596
Name:SANDERS, KRISTI E (PT)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:E
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 1:4210 MESA DR STE 110
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-3458
Mailing Address - Country:US
Mailing Address - Phone:940-320-6219
Mailing Address - Fax:940-320-6230
Practice Address - Street 1:4210 MESA DR STE 110
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-3458
Practice Address - Country:US
Practice Address - Phone:940-320-6219
Practice Address - Fax:940-320-6230
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072528225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX854T78OtherBCBS ORTHOTEXAS
TXTXB118162Medicare PIN