Provider Demographics
NPI:1598758476
Name:SANCHEZ LEON, RAUL M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:M
Last Name:SANCHEZ LEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAUL
Other - Middle Name:MIGUEL
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6565 FANNIN ST
Mailing Address - Street 2:FONDREN 270
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2703
Mailing Address - Country:US
Mailing Address - Phone:713-441-3020
Mailing Address - Fax:713-790-4207
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:FONDREN 270
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-441-3020
Practice Address - Fax:713-790-4207
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30693207RP1001X
TXN9775207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282440101Medicaid
TX282440102Medicaid
AZ290015242OtherRAILROAD MEDICARE
TX8CU960OtherBLUE CROSS BLUE SHIELD
TX8EE939OtherBLUE CROSS BLUE SHIELD
AZAZ0725360OtherBCBS
TXP01045663OtherRR MEDICARE
AZ860911876OtherTAX ID
AZ1Z9606OtherHEALTHNET
AZ747652Medicaid
AZH76817Medicare UPIN
TX282440101Medicaid
AZZ140416Medicare PIN
AZ860911876OtherTAX ID
AZ747652Medicaid
TX346336YMVQMedicare PIN
TX346336ZSWDMedicare PIN