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General NPI Number Information
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NPI Number | 1255339362
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Entity Type | Individual
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Provider Name | BROC ENRIQUE RAMON DEPENA SANCHEZ APRN (NP)
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 9331 E LAKE HIGHLANDS DR
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City | DALLAS
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State | TX
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Zip | 75218-2723
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Country | US
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Telephone | 214-328-8378
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Fax |
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Provider Business Mailing Address
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Address Line | 9331 E LAKE HIGHLANDS DR
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City | DALLAS
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State | TX
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Zip | 75218-2723
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Country | US
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Telephone | 972-859-9934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP108991
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 090010-23
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP108991
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License Number State | TX
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