MEDICARE: GUADALUPE MARQUEZ DE SANCHEZ

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1265825087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUADALUPE MARQUEZ DE SANCHEZ

Provider Business Mailing Address
First Line	:	3921 BRECKENRIDGE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-1205
Country	:	US
Telephone Number	:	915-307-0684
Fax Number	:	915-239-9389

Provider Business Practice Location Address
First Line	:	3921 BRECKENRIDGE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-1205
Country	:	US
Telephone Number	:	915-307-0684
Fax Number	:	915-239-9389

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

Provider Enumeration Date	:	03/18/2015
Last Update Date	:	03/18/2015

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