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NPI Code Detail

MEDICARE: DR. MARIA FIDES M PACHECO M.D.

MEDICARE: DR. MARIA FIDES M PACHECO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12081P0004XSpinal Cord Injury Medicine PhysicianP3049TX
22081P0004XSpinal Cord Injury Medicine PhysicianMD420282PA

General Provider Information

NPI Number : 1134233752
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIA FIDES M PACHECO M.D.
Provider Business Mailing Address
First Line : 4500 S. LANCASTER RD
Second Line : SCI / 128
City : DALLAS
State : TX
Zip : 75216-7167
Country : US
Telephone Number : 214-857-1757
Fax Number :
Provider Business Practice Location Address
First Line : 4500 S LANCASTER RD
Second Line : SCI SERVICE (128)
City : DALLAS
State : TX
Zip : 75216-7167
Country : US
Telephone Number : 214-857-1757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 02/25/2019

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