Provider Demographics
NPI:1982601654
Name:FERNANDEZ, SANDRA G (MD)
Entity type:Individual
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First Name:SANDRA
Middle Name:G
Last Name:FERNANDEZ
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4243 E SOUTHCROSS BLVD
Mailing Address - Street 2:STE 205
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3727
Mailing Address - Country:US
Mailing Address - Phone:210-304-3500
Mailing Address - Fax:210-337-2909
Practice Address - Street 1:4243 E SOUTHCROSS BLVD
Practice Address - Street 2:STE 205
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3727
Practice Address - Country:US
Practice Address - Phone:210-304-3500
Practice Address - Fax:210-337-2909
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-10-17
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Provider Licenses
StateLicense IDTaxonomies
TXK1209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1170102-04OtherWELLMED MEDICAID
TX81091GOtherWELLMED MEDICARE