| Les T. Sandknop, D.o. Pa | |
|
1005 W Ralph Hall Pkwy Ste 221 Rockwall TX 75032-6662 | |
| (972) 771-9000 | |
| (972) 771-9002 |
| Full Name | Les T. Sandknop, D.o. Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1005 W Ralph Hall Pkwy Ste 221, Rockwall, Texas |
| Authorized Official Name and Position | Les T. Sandknop (OWNER) |
| Authorized Official Contact | 9727719081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Les T. Sandknop, D.o. Pa Po Box 1029 Rockwall TX 75087-1029 Ph: (972) 771-9081 | Les T. Sandknop, D.o. Pa 1005 W Ralph Hall Pkwy Ste 221 Rockwall TX 75032-6662 Ph: (972) 771-9000 |
| NPI Number | 1427093087 |
|---|---|
| Provider Enumeration Date | 06/18/2006 |
| Last Update Date | 11/08/2018 |
| Medicare PECOS PAC ID | 2860387578 |
|---|---|
| Medicare Enrollment ID | O20040219001016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427093087 | NPI | - | NPPES |
| 00367N | Other | TX | MEDICARE GROUP |
| 080455101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | F5359 (Texas) | Primary |
| Provider Name | Ronald W Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366445538 PECOS PAC ID: 6406939313 Enrollment ID: I20090114000756 |
| Provider Name | Les T Sandknop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336139807 PECOS PAC ID: 4688569254 Enrollment ID: I20100304000807 |
| Provider Name | Becky Wynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265566640 PECOS PAC ID: 3476680166 Enrollment ID: I20100429000326 |
| Provider Name | Margie A Chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366659542 PECOS PAC ID: 3274661202 Enrollment ID: I20100512000215 |
| Provider Name | Lauren M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063657302 PECOS PAC ID: 1355678806 Enrollment ID: I20190807001560 |
| Provider Name | Vineeth N Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689108680 PECOS PAC ID: 5597037531 Enrollment ID: I20200714001296 |
| Provider Name | Sarah Elizabeth Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356908339 PECOS PAC ID: 7618381609 Enrollment ID: I20210203001129 |
| Provider Name | Julia Bratton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861079212 PECOS PAC ID: 2668821406 Enrollment ID: I20231205004071 |
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