Provider Demographics
NPI:1902283773
Name:SANDLIN, ADAM P
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:P
Last Name:SANDLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 AIRPORT FWY
Mailing Address - Street 2:STE 300
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-3970
Mailing Address - Country:US
Mailing Address - Phone:817-300-3100
Mailing Address - Fax:817-952-3073
Practice Address - Street 1:6021 MORRISS RD
Practice Address - Street 2:STE 106
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3989
Practice Address - Country:US
Practice Address - Phone:469-635-2200
Practice Address - Fax:214-513-7800
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71188101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional