Provider Demographics
NPI:1184842494
Name:SANCHEZ, JUAN ANTONIO (LBSW-IPR)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:ANTONIO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:LBSW-IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 FLOURNOY RD STE C
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4250
Mailing Address - Country:US
Mailing Address - Phone:361-660-2265
Mailing Address - Fax:361-668-4000
Practice Address - Street 1:408 FLOURNOY RD STE C
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4250
Practice Address - Country:US
Practice Address - Phone:361-660-2265
Practice Address - Fax:361-668-4000
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31648104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker