1023297652 NPI number — MRS. ELISABETH DIANE SANCHEZ FNP

Table of content: MRS. ELISABETH DIANE SANCHEZ FNP (NPI 1023297652)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023297652 NPI number — MRS. ELISABETH DIANE SANCHEZ FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANCHEZ
Provider First Name:
ELISABETH
Provider Middle Name:
DIANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SANCHEZ
Provider Other First Name:
ELISABETH
Provider Other Middle Name:
DIANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1023297652
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10727 STONE ISLE COURT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77407-7354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-513-2616
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10727 STONE ISLE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77407-1740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-513-2616
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  595980 , 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)

  • Identifier: 8K4591 . This is a "MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".