Provider Demographics
NPI:1396217287
Name:SANCHEZ, ABRAHAM (PA)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 N ZANG BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4263
Mailing Address - Country:US
Mailing Address - Phone:214-941-4243
Mailing Address - Fax:214-941-1153
Practice Address - Street 1:810 N ZANG BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4263
Practice Address - Country:US
Practice Address - Phone:214-941-4243
Practice Address - Fax:214-941-1153
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12955363A00000X
390200000X
TXPA14242363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN12955OtherLICENSE