Provider Demographics
NPI:1063002178
Name:SANCHO, ALFREDO R JR (RN)
Entity Type:Individual
Prefix:MR
First Name:ALFREDO
Middle Name:R
Last Name:SANCHO
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W ELSMERE PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-4540
Mailing Address - Country:US
Mailing Address - Phone:210-897-1614
Mailing Address - Fax:
Practice Address - Street 1:1310 W ELSMERE PL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-4540
Practice Address - Country:US
Practice Address - Phone:210-897-1614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1003238163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse