Healthcare Provider Details

I. General information

NPI: 1801314281
Provider Name (Legal Business Name): STACEY RENE SANCHEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2017
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 MORGAN AVE
CORPUS CHRISTI TX
78404-3554
US

IV. Provider business mailing address

8522 BROADWAY STE 216
SAN ANTONIO TX
78217-6456
US

V. Phone/Fax

Practice location:
  • Phone: 210-874-5260
  • Fax:
Mailing address:
  • Phone: 210-874-5260
  • Fax: 210-864-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP135014
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP135014
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: