Healthcare Provider Details

I. General information

NPI: 1407273683
Provider Name (Legal Business Name): THERESA SANCHEZ PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

01 I-25 INTERCHANGE
BELEN NM
87002
US

IV. Provider business mailing address

PO BOX 201
JARALES NM
87023-0201
US

V. Phone/Fax

Practice location:
  • Phone: 505-864-0270
  • Fax:
Mailing address:
  • Phone: 505-459-6184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6406
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: