Healthcare Provider Details

I. General information

NPI: 1538309786
Provider Name (Legal Business Name): FERNANDO SANCHEZ, I.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2009
Last Update Date: 06/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 DEL CT # 1
LAREDO TX
78041-2276
US

IV. Provider business mailing address

PO BOX 452249
LAREDO TX
78045-0055
US

V. Phone/Fax

Practice location:
  • Phone: 956-717-2328
  • Fax: 956-717-2395
Mailing address:
  • Phone: 956-717-2328
  • Fax: 956-717-2395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberN1877
License Number StateTX

VIII. Authorized Official

Name: FERNANDO SANCHEZ
Title or Position: OWNER
Credential: M.D.
Phone: 956-744-1212