Provider Demographics
NPI:1497786107
Name:SANCHEZ, JOSE GUADALUPE JR (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:GUADALUPE
Last Name:SANCHEZ
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 38
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-0038
Mailing Address - Country:US
Mailing Address - Phone:956-797-2002
Mailing Address - Fax:956-797-3361
Practice Address - Street 1:106 N. MAIN
Practice Address - Street 2:
Practice Address - City:LA FERIA
Practice Address - State:TX
Practice Address - Zip Code:78559-0038
Practice Address - Country:US
Practice Address - Phone:956-797-2002
Practice Address - Fax:956-797-3361
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03074363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA03074OtherLICENSE/PERMIT
TXL0134463OtherCONTROLLED SUBSTANCES DPS
TXL0134463OtherCONTROLLED SUBSTANCES DPS
TX8C6394Medicare PIN
TXL0134463OtherCONTROLLED SUBSTANCES DPS