Provider Demographics
NPI:1982794632
Name:SANDERS, MICHAEL BLAKE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BLAKE
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7715 SAN JACINTO PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75032-3215
Mailing Address - Country:US
Mailing Address - Phone:214-245-4424
Mailing Address - Fax:972-618-4000
Practice Address - Street 1:7715 SAN JACINTO PL
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75032-3215
Practice Address - Country:US
Practice Address - Phone:214-245-4424
Practice Address - Fax:972-618-4000
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2013-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL7158207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CU075OtherBCBSTX
TXB128948OtherMEDICARE PTAN
TXB128948OtherMEDICARE PTAN