Provider Demographics
NPI:1669485504
Name:SANCHEZ, MANUEL J (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:J
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N WARE RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8055
Mailing Address - Country:US
Mailing Address - Phone:956-668-0044
Mailing Address - Fax:956-687-9747
Practice Address - Street 1:501 N WARE RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8055
Practice Address - Country:US
Practice Address - Phone:956-668-0044
Practice Address - Fax:956-687-9747
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2899207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121437102Medicaid
TX5757960001Medicare NSC
TX85Y710Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TXC21521Medicare UPIN