MEDICARE: DR. BROC ENRIQUE RAMON DEPENA SANCHEZ APRN (NP)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP108991	TX
2	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	090010-23	NH
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP108991	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	090010-23	OTHER	NH	CLINIC NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	02687	OTHER	TX	STATE PRESCRIPTIVE NUMBER
4	090010-23	OTHER	NH	FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
5	69929	OTHER	NM	CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER
6	NUR-APRN-LIC-204079	OTHER	MT	CLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH
7	APRN-3756	OTHER	HI	FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
8	0327382	OTHER	TX	FAMILY NURSE PRACTITIONER -BOARD CERTIFICATION-ANCC
9	090010-23	OTHER	NH	FAMILY NURSE PRACTITIONER
10	AP108991	OTHER	TX	ADVANCED PRACTICE REGISTERED NURSE LICENSE
11	AP61367800	OTHER	WA	ADVANCED RN PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
12	NUR-APRN-LIC-204079	OTHER	MT	CERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER
13	249794	OTHER	TX	REGISTERED NURSE LICENSE
14	60129595	OTHER	TX	PREVIOUS-DEPARTMENT OF PUBLIC SAFETY -CONTROLLED SUBSTANCE REGISTRATION
15	AP61367800	OTHER	WA	CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER
16	APRN-3756	OTHER	HI	FAMILY NURSE PRACTITIONER
17	NUR-APRN-LIC-204079	OTHER	MT	CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER
18	108122	OTHER	HI	REGISTERED NURSE
19	69929	OTHER	NM	CERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
20	APRN-3756	OTHER	HI	ADULT PSYCHIATRIC & MENTAL HEALTH CLINICAL NURSE SPECIALISTS
21	0359671-35	OTHER	TX	PSYCHIATRIC AND MENTAL HEALTH NURSE PRACTITIONER BOARD CERTIFICATION-ANCC
22	AP61367799	OTHER	WA	CLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH
23	RN61367656	OTHER	WA	REGISTERED NURSE

General Provider Information

NPI Number	:	1255339362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BROC ENRIQUE RAMON DEPENA SANCHEZ APRN (NP)

Provider Business Mailing Address
First Line	:	9331 E LAKE HIGHLANDS DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-2723
Country	:	US
Telephone Number	:	972-859-9934
Fax Number	:

Provider Business Practice Location Address
First Line	:	9331 E LAKE HIGHLANDS DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-2723
Country	:	US
Telephone Number	:	214-328-8378
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	03/07/2023

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