Healthcare Provider Details

I. General information

NPI: 1497717078
Provider Name (Legal Business Name): KRISTINA N SANCHEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA N VANDENBOSCH MD

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 06/26/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600B MONTGOMERY BLVD NE STE 100
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

PO BOX 91224
ALBUQUERQUE NM
87199-1224
US

V. Phone/Fax

Practice location:
  • Phone: 505-924-5840
  • Fax: 505-924-5841
Mailing address:
  • Phone: 505-924-5840
  • Fax: 505-924-5841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberMD2014-0808
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number43226
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberP9455
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2014-0808
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: