Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 2081107 | TX |
Y | 213ES0000X | Sports Medicine | 2081107 | TX |
NPI | 1023662517 |
---|---|
Provider Name | Rodolfo Sanchez |
First Address | Arlington, TX 76011-4992 |
Second Address | Arlington, TX 76011-4992 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2019 |
Last Update Date | 01/08/2019 |