Provider Demographics
NPI:1124177423
Name:SANFORD T. WARD, D.O., PROFESSIONAL ASSOCIATIION
Entity type:Organization
Organization Name:SANFORD T. WARD, D.O., PROFESSIONAL ASSOCIATIION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:T
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:806-795-4336
Mailing Address - Street 1:3719 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1329
Mailing Address - Country:US
Mailing Address - Phone:806-795-4336
Mailing Address - Fax:806-785-4309
Practice Address - Street 1:3719 22ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1329
Practice Address - Country:US
Practice Address - Phone:806-795-4336
Practice Address - Fax:806-785-4309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2383207Y00000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00AX97OtherBCBS
TX00AX97Medicare ID - Type Unspecified
TX00AX97OtherBCBS