Organization Name: | MEDICAL ASSOCIATES FOR LTC |
NPI Number: | 1841487212 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH KAY SANDERS (OWNER) |
Mailing Address: | 437 Hideaway Ln E Hideaway |
State: | TX US |
Postal Code: | 757715213 |
Phone Number: | 9035306745 |
Fax Number: | 9038828134 |
NPI Enumeration Date: | 10/01/2007 |
NPI Last Update Date: | 05/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 244705 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |