MEDICARE: MICAELA SANCHEZ WHNP

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	363LW0102X	Women's Health Nurse Practitioner	1050828	TX

General Provider Information

NPI Number	:	1821764168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAELA SANCHEZ WHNP

Provider Business Mailing Address
First Line	:	2042 CEDAR CREST BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-4314
Country	:	US
Telephone Number	:	214-356-9569
Fax Number	:

Provider Business Practice Location Address
First Line	:	2914 S BUCKNER BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75227-6907
Country	:	US
Telephone Number	:	214-275-5256
Fax Number	:

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

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	08/17/2021

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