Healthcare Provider Details

I. General information

NPI: 1306498423
Provider Name (Legal Business Name): SABRINA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 W SEMANDS ST
CONROE TX
77301-1867
US

IV. Provider business mailing address

23318 LOW RIDGE RD
SPRING TX
77373-7050
US

V. Phone/Fax

Practice location:
  • Phone: 936-756-5598
  • Fax:
Mailing address:
  • Phone: 210-630-2356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number972120
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number972120
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: