Provider Demographics
NPI:1235407479
Name:SANCHEZ, JORGE RENE (DC)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:RENE
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 S GREAT SOUTHWEST PKWY STE 505
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-3546
Mailing Address - Country:US
Mailing Address - Phone:972-647-2400
Mailing Address - Fax:972-623-3400
Practice Address - Street 1:2133 S GREAT SOUTHWEST PKWY STE 505
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-3546
Practice Address - Country:US
Practice Address - Phone:972-647-2400
Practice Address - Fax:972-623-3400
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor