1396724688 NPI number — DR. SYDNEY FRANK SANCHEZ O.D.

Table of content: DR. SYDNEY FRANK SANCHEZ O.D. (NPI 1396724688)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396724688 NPI number — DR. SYDNEY FRANK SANCHEZ O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANCHEZ
Provider First Name:
SYDNEY
Provider Middle Name:
FRANK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SANCHEZ
Provider Other First Name:
S.
Provider Other Middle Name:
FRANK
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1396724688
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
470 ACTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARKSVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71351-2932
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-253-4582
Provider Business Mailing Address Fax Number:
318-253-8766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
470 ACTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARKSVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71351-2932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-253-4582
Provider Business Practice Location Address Fax Number:
318-253-8766
Provider Enumeration Date:
01/13/2006

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: 152W00000X , with the licence number:  920-033T , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 180003537 , issued by the state of ( LA ) . This identifiers is of the category "MEDICARE PIN".
  • Identifier: 1321745 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DP7805 . This is a "RALIROAD MEDICARE PTAN" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 721013674 . This is a "TAX ID NUMBER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: T19627 , issued by the state of ( LA ) . This identifiers is of the category "MEDICARE UPIN".
  • Identifier: 5DK99 . This is a "MEDICARE PTAN" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 49198 . This is a "MEDICARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 0215000001 . This is a "MEDICARE DME" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".