Provider Demographics
NPI:1902921182
Name:ROLAND KENT SANCHEZ, MD
Entity Type:Organization
Organization Name:ROLAND KENT SANCHEZ, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-864-7781
Mailing Address - Street 1:703 SOUTH CHRISTOPHER ROAD
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002
Mailing Address - Country:US
Mailing Address - Phone:505-864-7781
Mailing Address - Fax:505-864-3360
Practice Address - Street 1:703 SOUTH CHRISTOPHER ROAD
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002
Practice Address - Country:US
Practice Address - Phone:505-864-7781
Practice Address - Fax:505-864-3360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM21642Medicaid
1427083369OtherNPI
NM2126492OtherOLD MEDICARE NUMBER
NM21642Medicaid
NM0342930001Medicare NSC