Provider Demographics
NPI:1821266412
Name:DR. MARVIN SANCHEZ, DPM, PODIATRIC MEDICINE
Entity Type:Organization
Organization Name:DR. MARVIN SANCHEZ, DPM, PODIATRIC MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-849-4457
Mailing Address - Street 1:PO BOX 40189
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-1189
Mailing Address - Country:US
Mailing Address - Phone:210-849-4457
Mailing Address - Fax:210-949-0960
Practice Address - Street 1:19432 DAVIS STREET
Practice Address - Street 2:
Practice Address - City:LYTLE
Practice Address - State:TX
Practice Address - Zip Code:78052
Practice Address - Country:US
Practice Address - Phone:210-849-4457
Practice Address - Fax:210-949-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00325PMedicare PIN
TXU86751Medicare UPIN
TX5505510001Medicare NSC