Provider Demographics
NPI:1932975802
Name:PODEHALE, SANDRINE BIJOUX (NP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRINE
Middle Name:BIJOUX
Last Name:PODEHALE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 KIMBLETON CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2048
Mailing Address - Country:US
Mailing Address - Phone:512-436-4697
Mailing Address - Fax:
Practice Address - Street 1:2603 KIMBLETON CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2048
Practice Address - Country:US
Practice Address - Phone:512-436-4697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2209320363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health