DR. BERTRAND TANKOUO SANDJONG (NPI# 1386291565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386291565 |
| Entity Type | Individual |
| Full Name | DR. BERTRAND TANKOUO SANDJONG |
| Credential | PH.D., D(ABMM) |
| Practice Address |
5117 34th St Ste B Lubbock TX 79410-2304 |
| Practice Telephone | 8312358266 |
| Practice Fax Number | 8069932000 |
| Mailing Telephone | 8312358266 |
| Mailing Fax Number | 8069932000 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
1256 | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
5117 34TH ST STE B |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-2304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881259760 | Microit Diagnostics Inc | Clinical Medical Laboratory | 5117 34th St Ste B, Lubbock, TX 79410-2304 | 2019-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
| Find all providers in zip 79410 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033719059 | Kenesha Barnes | Pathology | 9120 Monica St, Beaumont, TX 77707-4634 | 2020-10-28 |
| 1417574922 | Thomas King Huard | Pathology | 112 Bellagio Dr, Austin, TX 78734-5081 | 2020-06-30 |
| 1932740313 | Stephanie Halliday | Pathology | 2023 Gentryside Dr Unit 102, Houston, TX 77077-3657 | 2019-10-07 |
| 1699232504 | Xia Wang | Pathology | 1920 Country Place Pkwy # 100, Pearland, TX 77584-2282 | 2019-02-27 |
| 1982178000 | Quantacia Miner | Pathology | 613 Bridgewood Cir Apt 524, Fort Worth, TX 76112-1729 | 2019-01-11 |
| 1710479530 | Herbert A Fritsche Jr. | Pathology | 12117 Bee Caves Road, Building 3 Suite 100, Austin, TX 78738 | 2018-06-06 |
| 1336694496 | Pheleicia Biggins | Pathology | 4116 Summitt Ridge Dr, Dallas, TX 75216-6016 | 2016-08-18 |
| 1447671292 | Alvin Spiekerman | Pathology | 16300 Addison Rd, Addison, TX 75001-5346 | 2013-12-20 |
| 1659704724 | Christopher Byers | Pathology | 6682 Escondido St, Irving, TX 75039-4208 | 2013-08-13 |
| 1740567841 | Stephen Ray Harlow | Pathology | 201 Laurence, #108, Heath, TX 75032 | 2011-11-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.