Provider Demographics
NPI:1598715534
Name:SANCHEZ-BARRETTO, SHIRLEY (MD)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:SANCHEZ-BARRETTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:KNOX CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79529-0488
Mailing Address - Country:US
Mailing Address - Phone:940-657-3906
Mailing Address - Fax:940-657-3909
Practice Address - Street 1:712 E SOUTH 5TH ST
Practice Address - Street 2:
Practice Address - City:KNOX CITY
Practice Address - State:TX
Practice Address - Zip Code:79529-2105
Practice Address - Country:US
Practice Address - Phone:940-657-3906
Practice Address - Fax:940-657-3909
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7877207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123203503Medicaid
TX123203503Medicaid
TXN00014Medicare UPIN
TXE31708Medicare UPIN