Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | E7263 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | E7263 | TX |
N | 207R00000X | Internist | E7263 | TX |
N | 111NI0900X | Internist | E7263 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | E7263 | TX |
NPI | 1073596441 |
---|---|
Provider Name | Sergio Sanchez-Zambrano |
First Address | Troy, MI 48099-1239 |
Second Address | Fort Worth, TX 76102-2651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 10/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122571604 | (05) | TX |
B27770 | (02) |