Clyde Fagg Sanford III, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

E9970 Issued in TX

Practice address

703 S Fleishel Ave
Ste 4000
Tyler, TX 75701-2015

Phone

(903) 606-7000

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)Also: Interventional Cardiology

Education

Washington University School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
• Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
• Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
• Christus Mother Frances Hospital- Winnsboro Hospital, Winnsboro, TX, CCN 451381

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fsanford7699@christushealth.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Medicare reassignment NPD
• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• University of Texas Health Science Center at Tyler

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
  • NPI 1992868186
  NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  NPD
• Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1922058304
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Christus Hopkins Health Alliance

  • General Acute Care Hospital
  • Sulphur Springs, TX
  • NPI 1033568621
  Care Compare affiliation
• Mother Frances Hospital Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Mother Frances Hospital-Winnsboro

  • Critical Access Hospital
  • Winnsboro, TX
  • NPI 1659308948
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1528053857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S FLEISHEL AVE",
            "address_2": "STE 4000",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012015",
            "telephone_number": "903-606-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1783 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757015869",
            "country_code": "US",
            "telephone_number": "903-595-2283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2026 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757665822",
            "country_code": "US",
            "telephone_number": "903-586-5678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3201 S Loop 256",
            "address_purpose": "LOCATION",
            "city": "Palestine",
            "state": "TX",
            "postal_code": "758016901",
            "country_code": "US",
            "telephone_number": "903-723-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 S Fleishel Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012004",
            "country_code": "US",
            "telephone_number": "903-606-2299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015580",
            "country_code": "US",
            "telephone_number": "903-315-2777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 E Marshall Ave Ste 5008",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015557",
            "country_code": "US",
            "telephone_number": "903-315-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 S Fleishel Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012004",
            "country_code": "US",
            "telephone_number": "903-606-5777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754822138",
            "country_code": "US",
            "telephone_number": "903-885-3181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "CLYDE",
        "middle_name": "FAGG",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "E9970",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "E9970",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E9970",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128834206",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4538099",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "038665009",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128834202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "089421J",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "752616977007",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Sandoval
• Norma Sandoval
• Sandra Harper PLLC
• Sandy Harper PC
• Peter Michael Sanfelippo
• Dinesh Kumar Sangana, MD
• Suja Sanjay
• Melisa Santana
• Jennifer Horton Santibanez, PHARMD
• Santo Chiropractic Neurology Center, Inc.

• Cardiovascular Disease Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.