Provider Demographics
NPI:1558689190
Name:SANCHEZ, MARIA LOURDES (SLP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LOURDES
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16019 HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-6524
Mailing Address - Country:US
Mailing Address - Phone:817-292-8787
Mailing Address - Fax:817-900-7247
Practice Address - Street 1:6601 MONTANA AVE STE G&H
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-2155
Practice Address - Country:US
Practice Address - Phone:915-838-7604
Practice Address - Fax:915-772-4633
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149984001Medicaid
TX149984001Medicaid