Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1554 | TX |
NPI | 1407931397 |
---|---|
Provider Name | Dr. Marvin Sanchez |
First Address | San Antonio, TX 78229-1189 |
Second Address | Lytle, TX 78052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 14/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
148109501 | (05) | TX |
U86751 | (02) | TX |