1720260813 NPI number — SERGIO SANCHEZ ZAMBRANO, MD, PA

Table of content: (NPI 1720260813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720260813 NPI number — SERGIO SANCHEZ ZAMBRANO, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERGIO SANCHEZ ZAMBRANO, MD, 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:
Provider Other Organization Name Type Code:
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:
1720260813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
811 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEBURNE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76033-3816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-558-4403
Provider Business Mailing Address Fax Number:
817-641-3272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1650 W ROSEDALE ST
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76104-7400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-558-4403
Provider Business Practice Location Address Fax Number:
817-641-3272
Provider Enumeration Date:
11/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SANCHEZ ZAMBRANO
Authorized Official First Name:
SERGIO
Authorized Official Middle Name:
Authorized Official Title or Position:
MD, PA
Authorized Official Telephone Number:
817-558-4403

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  E7263 , 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)





Copyright © 2007-2025 www.npivalidator.com