1003154881 NPI number — BIANCA SANCHEZ, PA

Table of content: (NPI 1003154881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003154881 NPI number — BIANCA SANCHEZ, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIANCA SANCHEZ, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LITTLE PEOPLE'S DENTISTRY BRACES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003154881
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4706 RIVERSTONE BLVD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MISSOURI CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-261-0020
Provider Business Mailing Address Fax Number:
281-261-0024

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4706 RIVERSTONE BLVD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MISSOURI CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-261-0020
Provider Business Practice Location Address Fax Number:
281-261-0024
Provider Enumeration Date:
01/29/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANCHEZ
Authorized Official First Name:
BIANCA
Authorized Official Middle Name:
ALINEZ
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-261-0020

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  18173 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)