Provider Demographics
NPI:1386980464
Name:SANDOVAL, SIOMARA CASTRO (NP)
Entity type:Individual
Prefix:MS
First Name:SIOMARA
Middle Name:CASTRO
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:16107 KENSINGTON DR STE 126
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4224
Mailing Address - Country:US
Mailing Address - Phone:817-838-1622
Mailing Address - Fax:713-439-7995
Practice Address - Street 1:7710 GARTH RD STE A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-8809
Practice Address - Country:US
Practice Address - Phone:281-783-8162
Practice Address - Fax:713-439-7995
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX605601363LF0000X
TXAP122835363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily