S4 SAND PLLC (NPI# 1679013536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679013536 |
| Entity Type | Organization |
| Organization Name | S4 SAND PLLC |
| Practice Address |
3909 Yarberry Ct Roanoke TX 76262-3355 |
| Mailing Address |
Po Box 502 Roanoke TX 76262-0502 |
| Practice Telephone | 8177332002 |
| Mailing Telephone | 8177332002 |
| Enumeration Date | 2017-02-26 |
| Last Update Date | 2017-02-26 |
| Authorized Official Name | STEFANIE SANDERSON (OWNER/PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 8177332002 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA04819 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3909 YARBERRY CT |
| City | ROANOKE |
| State | TX |
| Zip Code | 76262-3355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025611 | Freeform Chiropractic Trophy Club LLC | Chiropractor | 2240 Sh 114, Suite 650, Trophy Club, TX 76262 | 2020-02-20 |
| 1932748498 | Legacy Physical Therapy and Wellness | Physical Therapist | 351 N Byron Nelson Blvd, Suite 110, Roanoke, TX 76262 | 2020-01-02 |
| 1497399687 | Roanoke Foot & Ankle Institute, Pllc | Podiatrist | 351 W Byron Nelson Blvd, Suite 100, Roanoke, TX 76262 | 2019-10-31 |
| 1710470810 | Maria Guadalupe Madera | Dentist | 5000 Highway 114, Unit 130, Northlake, TX 76262 | 2018-06-13 |
| 1912414251 | 6 Day Dental Group - Roanoke, Pllc | Clinic/Center | 200 Tx-114, Roanoke, TX 76262 | 2018-01-09 |
| 1144746561 | Lone Star Neurosurgical Assistants | Physician Assistant | 1270 Casa Bella Ct, Westlake, TX 76262 | 2017-08-17 |
| 1710347562 | Randolph R West Dds Pllc | Dentist | 295 W. Byron Nelson Blvd, Ste 304, Roanoke, TX 76262 | 2016-03-07 |
| 1912367228 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 35 Arta Dr, Westlake, TX 76262 | 2016-02-29 |
| 1952760050 | Roanoke Dental Group,pc | Dentist | 1320 N Hwy 377 Suite 100, Roanoke, TX 76262 | 2016-02-17 |
| 1942683115 | Fatima Naurose Siraj | Dentist | 860 East Highway 114 Ideal Dental, Suite 200, Roanoke, TX 76262 | 2015-07-07 |
| Find all providers in zip 76262 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952780496 | Laura Rosalie Tiffany-harrod | Physician Assistant | 14636 Shave Lake Drive, Roanoke, TX 76262 | 2015-05-28 |
| 1770832388 | Hillery Gabrielle Key | Physician Assistant | 13709 Ponderosa Ranch Rd, Roanoke, TX 76262-4535 | 2012-08-29 |
| 1275041527 | Jennifer Caroline Dudley | Physician Assistant | 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 | 2018-01-19 |
| 1801304407 | Tyler Bryce Kemp | Physician Assistant | 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 | 2018-01-17 |
| 1194231449 | Chelsea Behetherland Greenspan | Physician Assistant | 2001 Crystal Spring Ave Sw Ste 201, Roanoke, VA 24014-2465 | 2017-12-22 |
| 1548708670 | Mackenzie Meador Patterson | Physician Assistant | 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 | 2017-02-09 |
| 1013454776 | Kathryn Conrad Hoyt | Physician Assistant | 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 | 2017-01-19 |
| 1578009775 | Kathryn Lyon Tolmie | Physician Assistant | 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 | 2017-01-11 |
| 1518401272 | Brian Buccola | Physician Assistant | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2016-12-14 |
| 1306395561 | Rachel Elizabeth Rich | Physician Assistant | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2016-09-29 |
| Find all providers in ROANOKE | ||||
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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.