Provider Demographics
NPI:1558572511
Name:MARIO A. SANCHEZ, D.O.P.A.
Entity Type:Organization
Organization Name:MARIO A. SANCHEZ, D.O.P.A.
Other - Org Name:THE NEIGHBORHOOD DOCTOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DOPA
Authorized Official - Phone:956-797-2002
Mailing Address - Street 1:106 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-5003
Mailing Address - Country:US
Mailing Address - Phone:956-797-2002
Mailing Address - Fax:956-797-3361
Practice Address - Street 1:106 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LA FERIA
Practice Address - State:TX
Practice Address - Zip Code:78559-5003
Practice Address - Country:US
Practice Address - Phone:956-797-2002
Practice Address - Fax:956-797-3361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6573208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170554302Medicaid
TX0036MNOtherBCBS OF TX
TX170554301Medicaid
TX0036MNOtherBCBS OF TX
TX00421XMedicare ID - Type Unspecified