Provider Demographics
NPI:1801988928
Name:SANCHEZ, TEOFILO RESENDIZ III (MD)
Entity type:Individual
Prefix:DR
First Name:TEOFILO
Middle Name:RESENDIZ
Last Name:SANCHEZ
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1045 CENTRAL PARKWAY NORTH
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5024
Mailing Address - Country:US
Mailing Address - Phone:210-541-4500
Mailing Address - Fax:210-541-4508
Practice Address - Street 1:7913 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-6511
Practice Address - Country:US
Practice Address - Phone:210-680-9393
Practice Address - Fax:210-681-7906
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K4496OtherINDIVIDUAL PTAN
TXT0150108OtherTEXAS CONTROLLED SUBSTANCE
TX#8DJ151OtherBCBS HMO/PPO PROVIDER ID
TX1846859-09Medicaid
TX00U72ZOtherGROUP PTAN
TX00U72ZOtherGROUP PTAN
TXTXB157341Medicare PIN