Provider Demographics
NPI:1467260893
Name:SANDER, CATHERINE WAGNER
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:WAGNER
Last Name:SANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1821
Mailing Address - Country:US
Mailing Address - Phone:713-859-1422
Mailing Address - Fax:
Practice Address - Street 1:929 GESSNER RD STE 1390
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2469
Practice Address - Country:US
Practice Address - Phone:832-325-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1189514363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily