Provider Demographics
NPI:1376585505
Name:SANDBACH, JOHN FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANKLIN
Last Name:SANDBACH
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:6204 BALCONES DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4214
Practice Address - Country:US
Practice Address - Phone:512-302-1771
Practice Address - Fax:512-302-9774
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8157207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138245901Medicaid
TX138245910Medicaid
TX138245906Medicaid
TX138245904Medicaid
TX8R1541OtherBLUE CROSS OF TEXAS
TX8D5766Medicare PIN
TX138245910Medicaid
TX87692KMedicare PIN
TX138245906Medicaid