Basic Information
| Provider Information | |||||||||
| NPI: | 1053058834 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANCHEZ | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | JAMES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2951 N LOOP 336 W APT 136 | ||||||||
| Address2: | |||||||||
| City: | CONROE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773043646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8329482745 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25800 KUYKENDAHL RD | ||||||||
| Address2: | |||||||||
| City: | TOMBALL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773752892 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8327618483 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2022 | ||||||||
| LastUpdateDate: | 05/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183700000X | 319228 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Pharmacy Service Providers | Pharmacy Technician |
No ID Information.