Provider Demographics
NPI:1174846364
Name:SANCHEZ, REBECCA ANNETTE (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNETTE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5615 DEAUVILLE STE 240
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79706-2709
Mailing Address - Country:US
Mailing Address - Phone:432-221-5560
Mailing Address - Fax:817-299-1706
Practice Address - Street 1:5615 DEAUVILLE STE 240
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706-2709
Practice Address - Country:US
Practice Address - Phone:432-221-5560
Practice Address - Fax:432-580-5899
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06608363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
12118357OtherCAQH
TXPA06608OtherSTATE LICENSE