Provider Demographics
NPI:1841002250
Name:SANCHEZ, MELISSA D
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11231 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5846
Mailing Address - Country:US
Mailing Address - Phone:602-561-6353
Mailing Address - Fax:
Practice Address - Street 1:5010 N 95TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3042
Practice Address - Country:US
Practice Address - Phone:623-872-0945
Practice Address - Fax:623-872-0947
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLDO003132156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician