Individual provider Active NPI

Juan Carlos Sanchez Hernandez, SA-C

  • Surgical Assistant
  • Tyler, TX
National Provider Identifier
1962275586
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
23-688 Issued in TX
Practice address
11120 County Road 417
Tyler, TX 75704-4040
Phone
(903) 515-9669
NPI assigned
Nov 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 23-688 TX Primary

Addresses

Primary practice location

11120 County Road 417
Tyler, TX 75704-4040

Mailing address

11120 County Road 417
Tyler, TX 75704-4040
Phone (903) 515-9669

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23-688TXMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1962275586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 COUNTY ROAD 417",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757044040",
            "telephone_number": "903-515-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 COUNTY ROAD 417",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757044040",
            "telephone_number": "903-515-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ HERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "23-688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.