Provider Demographics
NPI:1962675538
Name:SANCHEZ, MICHELLE Y (PA)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:Y
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 830605
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78283-0605
Mailing Address - Country:US
Mailing Address - Phone:210-222-0333
Mailing Address - Fax:210-928-4837
Practice Address - Street 1:600 DIVISION AVE STE E
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-1336
Practice Address - Country:US
Practice Address - Phone:210-222-0333
Practice Address - Fax:210-227-4380
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA05560363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX205451201Medicaid