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General NPI Number Information
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NPI Number | 1427176668
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Entity Type | Individual
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Provider Name | DOMINGO R SANCHEZ JR. LSA
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | 6104 21ST ST
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City | LUBBOCK
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State | TX
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Zip | 79407-1606
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Country | US
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Telephone | 806-554-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 6104 21ST ST
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City | LUBBOCK
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State | TX
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Zip | 79407-1606
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Country | US
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Telephone | 806-554-5451
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | SA00094
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA00094
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License Number State | TX
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