Sanders, Mark Allen
Sanders, Mark Allen is an sole proprietor health care provider with primary practice located at 3437 W 7Th St , Fort Worth TX 76107-2718. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Legal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Sanders, Mark Allen can be contacted via phone (817) 688-1588.Contact Information
Primary practice address
3437 W 7Th St
Fort Worth TX 76107-2718
Phone: (817) 688-1588
Fax: (817) 423-7361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | K9653 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | K9653 | Texas |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207QH0002X | K8653 | Texas |
| Allopathic & Osteopathic Physicians / Legal Medicine | 209800000X | K9653 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036.131054 | Illinois |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | 036.131054 | Illinois |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207QH0002X | 036.131054 | Illinois |
| Allopathic & Osteopathic Physicians / Legal Medicine | 209800000X | 036.131054 | Illinois |
Profile Details
| NPI number | 1770544389 |
|---|---|
| LBN Legal business name | Sanders, Mark Allen |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Jun 24th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770544389 | NPPES |
| Texas | MEDICAID | 151887001 | |
| Texas | MEDICAID | 151887004 | |
| Texas | MEDICAID | 151887003 | |
| Texas | Other | 080186304 | |
| Texas | Other | 8B2215 |
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