Individual provider Active NPI

Broc Enrique Ramon Depena Sanchez, APRN (NP)

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1255339362
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP108991 Issued in TX
Practice address
9331 E Lake Highlands Dr
Dallas, TX 75218-2723
Phone
(214) 328-8378
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP108991 TX
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 090010-23 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP108991 TX Primary

Addresses

Primary practice location

9331 E Lake Highlands Dr
Dallas, TX 75218-2723

Mailing address

9331 E Lake Highlands Dr
Dallas, TX 75218-2723
Phone (972) 859-9934

Other identifiers 23

IdentifierTypeStateIssuer
090010-23OtherNHCLINIC NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH
FNP009228MedicaidTX
02687OtherTXSTATE PRESCRIPTIVE NUMBER
090010-23OtherNHFAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
69929OtherNMCERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER
NUR-APRN-LIC-204079OtherMTCLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH
APRN-3756OtherHIFAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
0327382OtherTXFAMILY NURSE PRACTITIONER -BOARD CERTIFICATION-ANCC
090010-23OtherNHFAMILY NURSE PRACTITIONER
AP108991OtherTXADVANCED PRACTICE REGISTERED NURSE LICENSE
AP61367800OtherWAADVANCED RN PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
NUR-APRN-LIC-204079OtherMTCERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER
249794OtherTXREGISTERED NURSE LICENSE
60129595OtherTXPREVIOUS-DEPARTMENT OF PUBLIC SAFETY -CONTROLLED SUBSTANCE REGISTRATION
AP61367800OtherWACERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER
APRN-3756OtherHIFAMILY NURSE PRACTITIONER
NUR-APRN-LIC-204079OtherMTCERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER
108122OtherHIREGISTERED NURSE
69929OtherNMCERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
APRN-3756OtherHIADULT PSYCHIATRIC & MENTAL HEALTH CLINICAL NURSE SPECIALISTS
0359671-35OtherTXPSYCHIATRIC AND MENTAL HEALTH NURSE PRACTITIONER BOARD CERTIFICATION-ANCC
AP61367799OtherWACLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH
RN61367656OtherWAREGISTERED NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
090010-23NHMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1255339362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9331 E LAKE HIGHLANDS DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182723",
            "telephone_number": "972-859-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9331 E LAKE HIGHLANDS DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182723",
            "telephone_number": "214-328-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "BROC",
        "middle_name": "ENRIQUE RAMON DEPENA",
        "name_prefix": "Dr.",
        "credential": "APRN (NP)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2023-03-07",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP108991",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NH",
            "license": "090010-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP108991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH",
            "identifier": "090010-23",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FNP009228",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PRESCRIPTIVE NUMBER",
            "identifier": "02687",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER",
            "identifier": "090010-23",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER",
            "identifier": "69929",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH",
            "identifier": "NUR-APRN-LIC-204079",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER",
            "identifier": "APRN-3756",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER -BOARD CERTIFICATION-ANCC",
            "identifier": "0327382",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "090010-23",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE REGISTERED NURSE LICENSE",
            "identifier": "AP108991",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED RN PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER",
            "identifier": "AP61367800",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER",
            "identifier": "NUR-APRN-LIC-204079",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "249794",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREVIOUS-DEPARTMENT OF PUBLIC SAFETY -CONTROLLED SUBSTANCE REGISTRATION",
            "identifier": "60129595",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER",
            "identifier": "AP61367800",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "APRN-3756",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER-FAMILY NURSE PRACTITIONER",
            "identifier": "NUR-APRN-LIC-204079",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "108122",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER-FAMILY PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER",
            "identifier": "69929",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT PSYCHIATRIC & MENTAL HEALTH CLINICAL NURSE SPECIALISTS",
            "identifier": "APRN-3756",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHIATRIC AND MENTAL HEALTH NURSE PRACTITIONER BOARD CERTIFICATION-ANCC",
            "identifier": "0359671-35",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL NURSE SPECIALIST-ADULT PSYCHIATRIC MENTAL HEALTH",
            "identifier": "AP61367799",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN61367656",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.