Provider Demographics
| NPI: | 1255339362 |
|---|---|
| Name: | SANCHEZ, BROC ENRIQUE RAMON DEPENA (APRN (NP)) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | BROC |
| Middle Name: | ENRIQUE RAMON DEPENA |
| Last Name: | SANCHEZ |
| Suffix: | |
| Gender: | M |
| Credentials: | APRN (NP) |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 9331 E LAKE HIGHLANDS DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | DALLAS |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75218-2723 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 972-859-9934 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 9331 E LAKE HIGHLANDS DR |
| Practice Address - Street 2: | |
| Practice Address - City: | DALLAS |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75218-2723 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 214-328-8378 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2005-07-12 |
| Last Update Date: | 2023-03-07 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | AP108991 | 363LF0000X, 363LP0808X |
| NH | 090010-23 | 364SP0809X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
| No | 364SP0809X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Adult |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NH | 090010-23 | Other | CLINIC NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH |
| TX | FNP009228 | Medicaid | |
| TX | 02687 | Other | STATE PRESCRIPTIVE NUMBER |
| NH | 090010-23 | Other | FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER |
| NM | 69929 | Other | CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER |
| MT | NUR-APRN-LIC-204079 | Other | CLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH |
| HI | APRN-3756 | Other | FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER |
| TX | 0327382 | Other | FAMILY NURSE PRACTITIONER -BOARD CERTIFICATION-ANCC |
| NH | 090010-23 | Other | FAMILY NURSE PRACTITIONER |
| TX | AP108991 | Other | ADVANCED PRACTICE REGISTERED NURSE LICENSE |
| WA | AP61367800 | Other | ADVANCED RN PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER |
| MT | NUR-APRN-LIC-204079 | Other | CERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER |
| TX | 249794 | Other | REGISTERED NURSE LICENSE |
| TX | 60129595 | Other | PREVIOUS-DEPARTMENT OF PUBLIC SAFETY -CONTROLLED SUBSTANCE REGISTRATION |
| WA | AP61367800 | Other | CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER |
| HI | APRN-3756 | Other | FAMILY NURSE PRACTITIONER |
| MT | NUR-APRN-LIC-204079 | Other | CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER |
| HI | 108122 | Other | REGISTERED NURSE |
| NM | 69929 | Other | CERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER |
| HI | APRN-3756 | Other | ADULT PSYCHIATRIC & MENTAL HEALTH CLINICAL NURSE SPECIALISTS |
| TX | 0359671-35 | Other | PSYCHIATRIC AND MENTAL HEALTH NURSE PRACTITIONER BOARD CERTIFICATION-ANCC |
| WA | AP61367799 | Other | CLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH |
| WA | RN61367656 | Other | REGISTERED NURSE |
| WA | RN61367656 | Other | REGISTERED NURSE |
