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Sunrise Total Mind Wellness Referrals

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Referred by

  • Referring physician: david CRUZ
  • Referring physician contact number: 9564892630
  • Practice name: David H Cruz MD PA
  • Practice contact name: WANDA PALACIOS
  • Practice phone number: 9567918008
  • Practice fax number: 8152054556

Patient information

  • Preferred name: miriam sanchez
  • DOB: August 28, 1981
  • Sex: Female
  • Race: White
  • Preferred language: Spanish
  • Marital status: Single
  • Contact number: 9565161832
  • Email address: miriamaco@yahoo.com
  • Address: 519 Valnera dr
    laredo, Texas 78043
  • Reason for visit:

    binge eating adha

Insurance information

  • Insurance policy holder’s name: miriam sanchez
  • Insurance policy holder’s DOB: August 28, 1981
  • Primary insurance ID: m4h27w16574
  • Primary insurance Group: w61513m048
  • Secondary insurance ID:
  • Secondary insurance Group: