Provider Demographics
NPI:1437119187
Name:SANDERS, DERIK PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:DERIK
Middle Name:PAUL
Last Name:SANDERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-5144
Mailing Address - Country:US
Mailing Address - Phone:830-333-9877
Mailing Address - Fax:830-333-9877
Practice Address - Street 1:604 MAIN ST
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5144
Practice Address - Country:US
Practice Address - Phone:830-333-9877
Practice Address - Fax:303-339-8778
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-26
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor