Provider Demographics
NPI:1366435307
Name:SANCHEZ, ELISA G
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:G
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 1:905 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-6616
Mailing Address - Country:US
Mailing Address - Phone:956-618-4648
Mailing Address - Fax:956-686-4377
Practice Address - Street 1:905 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6616
Practice Address - Country:US
Practice Address - Phone:956-618-4648
Practice Address - Fax:956-686-4377
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH03782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00DW90OtherBLUE CROSS BLUE SHIELD
TX032832001Medicaid
TX126612OtherVALUE OPTIONS
TX00DW90Medicare ID - Type Unspecified
TX032832001Medicaid