Provider Demographics
NPI:1811924947
Name:ORTIZ-SANCHEZ, VANESSA C (MD)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:C
Last Name:ORTIZ-SANCHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROCKMEAD DR
Mailing Address - Street 2:S:210
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-359-7788
Mailing Address - Fax:281-359-7888
Practice Address - Street 1:3201 HWY 71 EAST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602
Practice Address - Country:US
Practice Address - Phone:281-359-7788
Practice Address - Fax:281-359-7888
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ87032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188474401Medicaid
TX8J6059Medicare PIN
H06543Medicare UPIN
TX188474401Medicaid
TXTXB109324Medicare PIN