Active NPI
Mark R Sands, DPM
- Foot & Ankle Surgery Podiatrist
- Friendswood, TX
National Provider Identifier
1386646339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 1076
- Practice address
- 119 E Edgewood Dr
Friendswood, TX 77546-3818 - Phone
- (281) 996-9546
- Fax
- (281) 996-7645
- NPI assigned
- Jun 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 1076 | TX | Primary |
Addresses
Primary practice location
119 E Edgewood Dr
Friendswood, TX 77546-3818
Mailing address
PO Box 4572
Houston, TX 77210-4572
Phone (281) 996-9546
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004328912 | Other | TX | AETNA PROVIDER ID |
| P00174690 | Other | TX | RAILROAD MEDICARE |
| 119842602 | Medicaid | TX | |
| 8M1220 | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1076 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200441600000",
"number": "1386646339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4572",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104572",
"telephone_number": "281-996-9546",
"fax_number": "281-996-7645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 E EDGEWOOD DR",
"city": "FRIENDSWOOD",
"state": "TX",
"postal_code": "775463818",
"telephone_number": "281-996-9546",
"fax_number": "281-996-7645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDS",
"first_name": "MARK",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-02",
"last_updated": "2008-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "TX",
"license": "1076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER ID",
"identifier": "0004328912",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00174690",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119842602",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8M1220",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Friendswood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.