Provider Demographics
NPI:1366556193
Name:SANCHEZ, RAMON LARREA (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:LARREA
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-4906
Mailing Address - Country:US
Mailing Address - Phone:409-763-2452
Mailing Address - Fax:409-763-2458
Practice Address - Street 1:1501 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-4906
Practice Address - Country:US
Practice Address - Phone:409-763-2452
Practice Address - Fax:409-763-2458
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4701207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX070012339OtherRAILROAD MEDICARE
TX136906801Medicaid
TX070012339OtherRAILROAD MEDICARE
TXC21523Medicare UPIN
TX81640KMedicare PIN
TXCL8288Medicare PIN
TX82581FMedicare PIN
TX070010277Medicare PIN
TXCL8582Medicare PIN
TX00221KMedicare PIN
TX690008222Medicare PIN