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General NPI Number Information
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NPI Number | 1710360128
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Entity Type | Organization
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Legal Business Name | FERNANDO SANCHEZ CLINICAL NEUROPHYSIOLOGY CENTER PA
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 2110 LOMAS DEL SUR STE 111
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City | LAREDO
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State | TX
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Zip | 78046-5755
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Country | US
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Telephone | 956-267-6630
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Fax | 956-552-6747
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Provider Business Mailing Address
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Address Line | PO BOX 451927
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City | LAREDO
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State | TX
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Zip | 78045-0047
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Country | US
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Telephone | 956-267-6630
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Fax | 956-552-6747
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERNANDO SANCHEZ
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Credential | MD
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Telephone | 956-267-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | K3449
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License Number State | TX
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