=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588404107
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANDRA SANCHEZ PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2024
-----------------------------------------------------
Last Update Date | 07/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1409 S 9TH AVE STE 143
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-5549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-777-0483
-----------------------------------------------------
Fax | 956-705-2005
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1014 MISSISSIPPI RD
-----------------------------------------------------
City | RIO GRANDE CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78582-5757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-500-6235
-----------------------------------------------------
Fax | 956-705-2005
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 1163066
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------