ProviderBusinessMailingAddressFaxNumber = '9562532505'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1164173266
SANDRA VAN WYK, M.D., PLLC
715 CHESTNUT ST
BASTROP
TX
786023202
1316328016
VAN WYK
SANDRA
PO BOX 1200
BASTROP
TX
786021200
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