Provider Demographics
NPI:1396724688
Name:SANCHEZ, SYDNEY FRANK (OD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:FRANK
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:S.
Other - Middle Name:FRANK
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:470 ACTON RD
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-2932
Mailing Address - Country:US
Mailing Address - Phone:318-253-4582
Mailing Address - Fax:318-253-8766
Practice Address - Street 1:470 ACTON RD
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-2932
Practice Address - Country:US
Practice Address - Phone:318-253-4582
Practice Address - Fax:318-253-8766
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA920-033T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA49198OtherMEDICARE
LA5DK99OtherMEDICARE PTAN
LADP7805OtherRALIROAD MEDICARE PTAN
LA0215000001OtherMEDICARE DME
LA1321745Medicaid
LA721013674OtherTAX ID NUMBER
LA49198OtherMEDICARE
LA0215000001OtherMEDICARE DME